Ascariasis surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Ascariasis is usually managed conservatively with medical therapy but surgery may be indicated when medical management fails or complications arise.<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | |||
==Surgery== | ==Surgery== | ||
Some of the indications for the surgical management of ascariasis include:<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | Some of the indications for the surgical management of ascariasis include:<ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | ||
* Complete intestinal obstruction with inadequate decompression | * Complete [[intestinal obstruction]] with inadequate decompression | ||
* Lack of response within 24-48 hrs of medical management of obstruction | * Lack of response within 24-48 hrs of medical management of obstruction | ||
* Complications such as volvulus, intussusception or intestinal perforation | * Complications such as [[volvulus]], [[intussusception]] or [[intestinal perforation]] | ||
* Acute appendicitis | * [[Acute appendicitis]] | ||
* Worms trapped in ducts | * Worms trapped in ducts | ||
* Liver invasion by worms | * Liver invasion by worms | ||
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The surgical management for hepatobiliary infestation with ascaris include:<ref name="pmid18926454">{{cite journal| author=Astudillo JA, Sporn E, Serrano B, Astudillo R| title=Ascariasis in the hepatobiliary system: laparoscopic management. | journal=J Am Coll Surg | year= 2008 | volume= 207 | issue= 4 | pages= 527-32 | pmid=18926454 | doi=10.1016/j.jamcollsurg.2008.05.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18926454 }} </ref> | The surgical management for hepatobiliary infestation with ascaris include:<ref name="pmid18926454">{{cite journal| author=Astudillo JA, Sporn E, Serrano B, Astudillo R| title=Ascariasis in the hepatobiliary system: laparoscopic management. | journal=J Am Coll Surg | year= 2008 | volume= 207 | issue= 4 | pages= 527-32 | pmid=18926454 | doi=10.1016/j.jamcollsurg.2008.05.020 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18926454 }} </ref> | ||
* Endoscopic management: This entails endoscopic extraction of the worm | * Endoscopic management: This entails endoscopic extraction of the worm | ||
* Laparoscopic management: This often entails laparoscopic cholecystectomy, common bile duct exploration with parasite extraction, and T-tube placement. | {{#ev:youtube|kIW6H3MxWv0}} | ||
* Laparoscopic management: This often entails [[laparoscopic cholecystectomy]], [[common bile duct]] exploration with parasite extraction, and T-tube placement. | |||
====Intestinal obstruction due to ascariasis==== | ====Intestinal obstruction due to ascariasis==== | ||
Intestinal obstruction from ascariasis can be surgically managed via the following methods:<ref name="pmid8632280">{{cite journal| author=Villamizar E, Méndez M, Bonilla E, Varon H, de Onatra S| title=Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases. | journal=J Pediatr Surg | year= 1996 | volume= 31 | issue= 1 | pages= 201-4; discussion 204-5 | pmid=8632280 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8632280 }} </ref><ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | [[Intestinal obstruction]] from ascariasis can be surgically managed via the following methods:<ref name="pmid8632280">{{cite journal| author=Villamizar E, Méndez M, Bonilla E, Varon H, de Onatra S| title=Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases. | journal=J Pediatr Surg | year= 1996 | volume= 31 | issue= 1 | pages= 201-4; discussion 204-5 | pmid=8632280 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8632280 }} </ref><ref name="Principles and Practice">Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.</ref> | ||
* External "milking" of the obstructing bolus of worms from the ileum into the colon | * External "milking" of the obstructing bolus of worms from the [[ileum]] into the [[colon]] | ||
* Enterotomy to manually extract the worms | * Enterotomy to manually extract the worms | ||
[[File:IMAG0459.JPG|thumb|Worm extraction via enterotomy|center| Images courtesy of Dr. Imtiaz Ahmed Wani]] | |||
[[File:IMAG0459.JPG | |||
* Intestinal resection and end-to-end anastomosis if necessary | * Intestinal resection and end-to-end anastomosis if necessary | ||
[[File:Picture 094.jpg|center|thumb|Resected gangrenous loop of bowel during surgery in a child with intestinal obstruction from Ascaris lumbricoides - Images courtesy of Dr. Imtiaz Ahmed Wani]] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Emergency medicine]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 20:29, 29 July 2020
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Ascariasis surgery On the Web |
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American Roentgen Ray Society Images of Ascariasis surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Ascariasis is usually managed conservatively with medical therapy but surgery may be indicated when medical management fails or complications arise.[1]
Surgery
Some of the indications for the surgical management of ascariasis include:[1]
- Complete intestinal obstruction with inadequate decompression
- Lack of response within 24-48 hrs of medical management of obstruction
- Complications such as volvulus, intussusception or intestinal perforation
- Acute appendicitis
- Worms trapped in ducts
- Liver invasion by worms
Surgical therapy
Hepatobiliary ascariasis
The surgical management for hepatobiliary infestation with ascaris include:[2]
- Endoscopic management: This entails endoscopic extraction of the worm
{{#ev:youtube|kIW6H3MxWv0}}
- Laparoscopic management: This often entails laparoscopic cholecystectomy, common bile duct exploration with parasite extraction, and T-tube placement.
Intestinal obstruction due to ascariasis
Intestinal obstruction from ascariasis can be surgically managed via the following methods:[3][1]
- External "milking" of the obstructing bolus of worms from the ileum into the colon
- Enterotomy to manually extract the worms
- Intestinal resection and end-to-end anastomosis if necessary
References
- ↑ 1.0 1.1 1.2 Durand, Marlene (2015). "Chapter 288:Intestinal Nematodes (Roundworms)". Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
- ↑ Astudillo JA, Sporn E, Serrano B, Astudillo R (2008). "Ascariasis in the hepatobiliary system: laparoscopic management". J Am Coll Surg. 207 (4): 527–32. doi:10.1016/j.jamcollsurg.2008.05.020. PMID 18926454.
- ↑ Villamizar E, Méndez M, Bonilla E, Varon H, de Onatra S (1996). "Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases". J Pediatr Surg. 31 (1): 201–4, discussion 204-5. PMID 8632280.