26 March 2012
Vijay Chavan
Patient survives for more than two months with worm–infested tummy; discovery of one–and–a–half foot parasites shocks doctors
Two months ago, when 35–year–old Alka, a resident of Katraj, suffered abdominal pain little did she know that her intestines had been infested by parasitic worms. Assuming it to be a common pain, she treated herself with some painkillers. But last month, the pain became unbearable and rendered her almost bed–ridden. Finally, on February 27 she visited Dr Umesh Vaidya, head of the department of surgery of the Bharati Vidyapeeth Hospital, who conducted a surgery after initial investigation. However, Vaidya and his team were astonished to find 80 giant roundworms in her intestines during the rare surgery. Normally, one or two parasitic worms called the ‘ascaris lumbricoides’ are found in the human stomach. However, the doctors were even more surprised when they found that the worms were one–and–a–half–foot long and Alka had managed to survive with such a parasitic infestation for two months.
Now after the successful surgery, the doctors are planning to study Alka case to ascertain the cause behind the infestation.
Presently, the doctors are attributing the reason to consumption of contaminated water, poor sanitation facilities and eating unhealthy food. Alka, a mother of two, underwent a laparotomy surgery on March 1. She was unable to pass stools due to the pain. Dr Vaidya had suggested she take a USG (Abdomen and Pelvis) test which revealed she had acute mechanical bowel obstruction due to extensive roundworm infestation. The infestation was further confirmed by a CT scan.
Vaidya said, “In such a condition there was no option but to conduct a laparotomy surgery. We had presumed that there may be one or two worms. But while operating we were surprised to see 80 of them. Dr Rahul Kadam and Dr Vikas Wakalkar were part of our team.”
“During intra–operative findings, we saw that her small intestines were full of worms. As part of the surgery, all the worms were cleared through a minor enterotomy incision on the terminal ileum about one foot away from the ileocecal junction.” said Vaidya.
He said that they discovered that the entire large intestine was also infested with gaint worms. “Attempts to remove them through her rectum proved futile. Hence, a separate enterotomy on the descending colon was done and all the worms were removed,” Vaidya said.
“All of us were wondering how the lady survived with 80 gaint roundworms in her body. We had to remove each worm one by one from her tummy. We had to be extra careful to prevent the worms from falling inside the patient’s body. We ensured that not a single one was left behind as this could have proved fatal,” he added.
Why Laparotomy- The gaint roundworms were first paralysed two days before the surgery
- A dose of ‘pyrantel’ was administered orally to Alka
- Next day, the doctors looked for the possibility of extracting the worms naturally
- Getting a negative response, they decided to operate on her after 48 hours of dosage
- Tried to push the worms through the rectum and the anus to avoid a cut on the intestine
- When it proved futile, they decided to conduct a laparotomy surgery
It is a common parasitic roundworm found in human beings which causes the disease, ascariasis. The disease is prevalent in areas of poor sanitation and where human feces are used as fertiliser. The parasite has a life cycle of about three months. Ascariasis starts, when ascaris lumbricoides eggs are accidentally swallowed. They can be acquired through dirty fingers, water or food that has been contaminated with feces of an infected human. Larvae hatch from the eggs, penetrate the intestinal wall and enter the bloodstream
SymptomsBlockage of the biliary tract, diarrhoea, fever, nausea, obstruction of the bowel (which can be fatal), stomach ache, slower growing of a child or a teen, vomiting, weakness. breathing difficulty, cough and/or coughing up blood
Prevention- Avoid touching soil that might be
- contaminated with human feces
- Wash hands with water and soap before eating or preparing food
- Wash, peel or cook all fruits and vegetables before eating