Missed opportunity of deworming a Maasai boy from nomadic family leading to life threatening intestinal obstruction

Abstract
Mass deworming against soil-transmitted helminthiasis, including Ascaris lumbricoides (AL), is one of the largest public health interventions in low- and middle-income countries. The prevalence of A. lumbricoides in Tanzania is 6.8%. We present a 3-year-old male of a known Tanzanian nomadic tribe (Masaai tribe) with history of missed deworming, who was brought to the emergency department with a 3-day history of constipation, non-projectile, bilious vomiting, generalized abdominal distension and pain. He was diagnosed with intestinal obstruction by the use of a plain abdominal X-ray, which revealed marked gaseous distension of the stomach and bowels without significant air-fluid levels. He was initially treated with intravenous ceftriaxone 50 mg/kg, metronidazole 15 mg/kg and acetaminophen 15 mg/kg. An explorative laparotomy was then performed. Intraoperative findings demonstrated a dense collection of A. lumbricoides worms in the gangrenous proximal jejunum and duodenum. Thorough abdominal lavage was carried out and abdomen was closed.
Description
Full text article. Also available at https://doi.org/10.1093/jscr/rjaa096
Keywords
Ascaris lumbricoides, AL, Soil-transmitted helminthiasis, Public health, Public health interventions, Constipation, Nonprojectile, Bilious vomiting, Abdominal distension, Abdominal pain., Pain.
Citation
Pyuza, J. J., Andongolile, A. A., Issangya, C. E., Msuya, D., Yahaya, J. J., Shao, E. R., & Mremi, A. R. (2020). Missed opportunity of deworming a Maasai boy from nomadic family leading to life threatening intestinal obstruction. Journal of Surgical Case Reports, 2020(5).
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