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J Pediatr Infect Dis 2017; 12(01): 020-029
DOI: 10.1055/s-0037-1599117
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Imaging and Management of Childhood Ascariasis

Ebrahim Banderker
1   Department of Paediatric Radiology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
,
Marion Arnold
2   Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
,
Sharon Cox
2   Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
,
Luvo Gaxa
1   Department of Paediatric Radiology, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
› Author Affiliations
Further Information

Publication History

23 September 2016

11 October 2016

Publication Date:
02 March 2017 (online)

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Abstract

The human-specific roundworm Ascaris lumbricoides continues to cause significant morbidity and mortality across the world, especially within Asia, South America, and Africa, despite the success of mass eradication programs. Most childhood worm infestations are relatively asymptomatic. Children can, however, be burdened by ascariasis and its negative nutritional impact. Heavy worm loads are complicated by intestinal obstruction, bowel necrosis, and bowel perforation. Less frequently, biliary obstruction and its complications may also occur. Radiological detection of complications allow for early institution of the largely successful nonoperative management followed by curative antihelminthics. Imaging is essential in the monitoring and detection of ominous signs that direct emergency surgical intervention and follow-up.

Keywords

pediatric - roundworm - Ascaris lumbricoides - intestinal ascariasis - hepaotobiliary ascariasis - bowel obstruction
 

  • References

  • 1 Wani I, Rather M, Naikoo G, Amin A, Mushtaq S, Nazir M. Intestinal ascariasis in children. World J Surg 2010; 34 (5) 963-968
    CrossrefPubMedGoogle Scholar
  • 2 Park MS, Kim KW, Ha HK, Lee DH. Intestinal parasitic infection. Abdom Imaging 2008; 33 (2) 166-171
    CrossrefPubMedGoogle Scholar
  • 3 Ascariasis; Water-related diseases. Water Sanitation Health 2016. Available at: www.who.int/water_sanitation_health/diseases/ascariasis/en/ . Accessed August 30, 2016
    PubMedGoogle Scholar
  • 4 Khuroo MS. Ascariasis. Gastroenterol Clin North Am 1996; 25 (3) 553-577
    CrossrefPubMedGoogle Scholar
  • 5 Pockros PJ, Capozza TA. Helminthic infections of the liver. Curr Gastroenterol Rep 2004; 6 (4) 287-296
    CrossrefPubMedGoogle Scholar
  • 6 Baba AA, Ahmad SM, Sheikh KA. Intestinal ascariasis: the commonest cause of bowel obstruction in children at a tertiary care center in Kashmir. Pediatr Surg Int 2009; 25 (12) 1099-1102
    CrossrefPubMedGoogle Scholar
  • 7 Salman AB. Management of intestinal obstruction caused by ascariasis. J Pediatr Surg 1997; 32 (4) 585-587
    CrossrefPubMedGoogle Scholar
  • 8 Dold C, Holland CV. Ascaris and ascariasis. Microbes Infect 2011; 13 (7) 632-637
    CrossrefPubMedGoogle Scholar
  • 9 Mukhopadhyay B, Saha S, Maiti S , et al. Clinical appraisal of Ascaris lumbricoides, with special reference to surgical complications. Pediatr Surg Int 2001; 17 (5-6): 403-405
    CrossrefPubMedGoogle Scholar
  • 10 Rode H, Cullis S, Millar A, Cremin B, Cywes S. Abdominal complications of Ascaris lumbricoides in children. Pediatr Surg Int 1990; 5 (6) 397-401
    PubMedGoogle Scholar
  • 11 de Silva NR, Guyatt HL, Bundy DA. Worm burden in intestinal obstruction caused by Ascaris lumbricoides . Trop Med Int Health 1997; 2 (2) 189-190
    CrossrefPubMedGoogle Scholar
  • 12 Asaolu OS, Ofoezie OE, Onyeji OC. Ascaris lumbricoides (Ascariasis). Parasitology. Infectious disease and antimicrobial agents. Available at: www.antimicrobe.org/new/b17.asp . Accessed August 25, 2016
    PubMedGoogle Scholar
  • 13 Jenkins MQ, Beach MW. Intestinal obstruction due to ascariasis; report of thirty-one cases. Pediatrics 1954; 13 (5) 419-425
    PubMedGoogle Scholar
  • 14 Cheng TC. Host-parasite relationships. In: Cheng TC, , ed. General Parasitology, 2nd ed. Florida: Elsevier; 2012: 559
    Google Scholar
  • 15 Cooper PJ, Chico M, Sandoval C , et al. Human infection with Ascaris lumbricoides is associated with suppression of the interleukin-2 response to recombinant cholera toxin B subunit following vaccination with the live oral cholera vaccine CVD 103-HgR. Infect Immun 2001; 69 (3) 1574-1580
    CrossrefPubMedGoogle Scholar
  • 16 Madiba TE, Hadley GP. Surgical management of worm volvulus. S Afr J Surg 1996; 34 (1) 33-35 , discussion 35–36
    PubMedGoogle Scholar
  • 17 Ochoa B. Surgical complications of ascariasis. World J Surg 1991; 15 (2) 222-227
    CrossrefPubMedGoogle Scholar
  • 18 Palmer PES, Reeder MM. The Imaging of Tropical Diseases: With Epidemiological, Pathological and Clinical Correlation. Vol. 2. Berlin: Springer-Verlag; 2000
    Google Scholar
  • 19 Rodriguez EJ, Gama MA, Ornstein SM, Anderson WD. Ascariasis causing small bowel volvulus. Radiographics 2003; 23 (5) 1291-1293
    CrossrefPubMedGoogle Scholar
  • 20 Wani I, Maqbool M, Amin A , et al. Appendiceal ascariasis in children. Ann Saudi Med 2010; 30 (1) 63-66
    CrossrefPubMedGoogle Scholar
  • 21 Mishra PK, Agrawal A, Joshi M, Sanghvi B, Shah H, Parelkar SV. Intestinal obstruction in children due to Ascariasis: a tertiary health centre experience. Afr J Paediatr Surg 2008; 5 (2) 65-70
    CrossrefPubMedGoogle Scholar
  • 22 Villamizar E, Méndez M, Bonilla E, Varon H, de Onatra S. Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: experience with 87 cases. J Pediatr Surg 1996; 31 (1) 201-204 , discussion 204–205
    CrossrefPubMedGoogle Scholar
  • 23 Louw JH. Abdominal complications of Ascaris lumbricoides infestation in children. Br J Surg 1966; 53 (6) 510-521
    CrossrefPubMedGoogle Scholar
  • 24 Thein-Hlaing, Myat-Lay-Kyin, Hlaing-Mya, Maung-Maung. Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma. Ann Trop Paediatr 1990; 10 (1) 53-60
    CrossrefPubMedGoogle Scholar
  • 25 Herrick CA, Emery FE. Changes in the tonicity of smooth muscle produced by toxins of Ascaris lumbricoides . J Pharmacol 1929; 35 (2) 129-141
    PubMedGoogle Scholar
  • 26 Mokoena T, Luvuno FM. Conservative management of intestinal obstruction due to Ascaris worms in adult patients: a preliminary report. J R Coll Surg Edinb 1988; 33 (6) 318-321
    PubMedGoogle Scholar
  • 27 Ng KK, Wong HF, Kong MS, Chiu LC, Tan CF, Wan YL. Biliary ascariasis: CT, MR cholangiopancreatography, and navigator endoscopic appearance--report of a case of acute biliary obstruction. Abdom Imaging 1999; 24 (5) 470-472
    CrossrefPubMedGoogle Scholar
  • 28 Surendran N, Paulose MO. Intestinal complications of round worms in children. J Pediatr Surg 1988; 23 (10) 931-935
    CrossrefPubMedGoogle Scholar
  • 29 Ellman BA, Wynne JM, Freeman A. Intestinal ascariasis: new plain film features. AJR Am J Roentgenol 1980; 135 (1) 37-42
    CrossrefPubMedGoogle Scholar
  • 30 Hoffmann H, Kawooya M, Esterre P , et al. In vivo and in vitro studies on the sonographical detection of Ascaris lumbricoides . Pediatr Radiol 1997; 27 (3) 226-229
    CrossrefPubMedGoogle Scholar
  • 31 Lynser D, Handique A, Daniala C, Phukan P, Marbaniang E. Sonographic images of hepato-pancreatico-biliary and intestinal ascariasis: a pictorial review. Insights Imaging 2015; 6 (6) 641-646
    CrossrefPubMedGoogle Scholar
  • 32 Rana SS, Bhasin DK, Nanda M, Singh K. Parasitic infestations of the biliary tract. Curr Gastroenterol Rep 2007; 9 (2) 156-164
    CrossrefPubMedGoogle Scholar
  • 33 Mahmood T, Mansoor N, Quraishy S, Ilyas M, Hussain S. Ultrasonographic appearance of Ascaris lumbricoides in the small bowel. J Ultrasound Med 2001; 20 (3) 269-274
    CrossrefPubMedGoogle Scholar
  • 34 Malde HM, Chadha D. Roundworm obstruction: sonographic diagnosis. Abdom Imaging 1993; 18 (3) 274-276
    CrossrefPubMedGoogle Scholar
  • 35 Hefny AF, Saadeldin YA, Abu-Zidan FM. Management algorithm for intestinal obstruction due to ascariasis: a case report and review of the literature. Ulus Travma Acil Cerrahi Derg 2009; 15 (3) 301-305
    PubMedGoogle Scholar
  • 36 Kenamond CA, Warshauer DM, Grimm IS. Best cases from the AFIP: Ascaris pancreatitis. Radiographics 2006; 26 (5) 1567-1570
    CrossrefPubMedGoogle Scholar
  • 37 Wiersma R, Hadley GP. Small bowel volvulus complicating intestinal ascariasis in children. Br J Surg 1988; 75 (1) 86-87
    CrossrefPubMedGoogle Scholar
  • 38 Bektaş M, Dökmeci A, Cinar K , et al. Endoscopic management of biliary parasitic diseases. Dig Dis Sci 2010; 55 (5) 1472-1478
    CrossrefPubMedGoogle Scholar
  • 39 Javid G, Wani NA, Gulzar GM , et al. Ascaris-induced liver abscess. World J Surg 1999; 23 (11) 1191-1194
    CrossrefPubMedGoogle Scholar