East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
Vol. 12, No. 2, 2007, pp. 105-109
Bioline Code: js07050
Full paper language: English
Document type: Research Article
Document available free of charge
East and Central African Journal of Surgery, Vol. 12, No. 2, 2007, pp. 105-109
© Copyright 2007 - East and Central African Journal of Surgery
Laparotomy Due To Ascaris Lumbricoides at A.I.C Litein Mission Hospital – Kenya.|
Background: Ascariasis is known to be a cause of intestinal obstruction particularly in children. This study was aimed at determining the burden of Ascaris lumbricoides (round worms) in as a cause of mechanical intestinal obstruction requiring laparotomy for treatment in a rural setting.
Methods: The study was a 5-Year (2001-2005) descriptive retrospective study of cases of mechanical intestinal obstruction caused by mechanical blockage by Ascaris lumbricoides A.I.C Litein Mission Hospital, Kenya.
Results: During the study period under review, a total of 582 abdominal operations were
performed. In 69 (12%) of the patients the indication was intestinal obstruction caused by
Ascaris lumbricoides. Their ages ranged from 3 months to 44years.This accounted for 12%
of abdominal operations. The majority (94%) of these patients were aged 10 years or less.
Among children aged 10 years and below, ascariasis intestinal obstruction was the
commonest indication for laparotomy, contributing 33.5% of the 161 laparotomies done; it
was followed by intussusception. The commonest symptoms were abdominal pains (81%),
vomiting (58%) and constipation (64%) with an average duration of 3 days. The
commonest physical findings included abdominal mass (75%), toxic appearance (58%) and
dehydration (54%).Worm impaction was found in 96% of the patients, peritonitis in 13%
and gut necrosis in 6%. The commonest procedure carried out was enterotomy and worm
removal (90%). No death was recorded. The average length of hospital stay was 8 days
with an average cost of treatment of Ksh.28, 916 (US $ 596).
Conclusion: Ascaris lumbricoides is still a major cause of intestinal obstruction in children. This is an expensive surgical problem that can otherwise be prevented by improved sanitation and appropriate public health intervention. Clinical diagnosis remains the mainstay of diagnosis in the rural setting.