Ascaris lumbricoides roundworms visible on a plain -non-contrast- abdominal x-ray in a patient presenting with gastric outlet obstruction
Lykourgos Christos Alexakis
The Pan African Medical Journal. ;26:184. doi:10.11604/pamj..26.184.12232

Create an account  |  Sign in
EPI Helina 2017
"Better health through knowledge sharing and information dissemination "

Images in clinical medicine

Ascaris lumbricoides roundworms visible on a plain -non-contrast- abdominal x-ray in a patient presenting with gastric outlet obstruction

Lykourgos Christos Alexakis
Pan Afr Med J. 2017; 26:184. doi:10.11604/pamj.2017.26.184.12232. Published 29 Mar 2017



A 29 years old male from Bangladesh presented in the emergency department with severe abdominal pain and symptoms of gastric outlet obstruction. Epigastric tenderness, tachycardia, low grade fever, leucocytosis (WBC: 14900/microL) with neutrophilia (Neu:10900/microL) and eosinophilia (Eos:600/microL) were noted, as well as features of obstructive jaundice (increased AST, ALT, and total bilirubin). Stomach dilation was noted on a chest X-ray (A), while in a plain abdominal erect X-ray (C) tubular curvilinear soft tissue densities in a jejunal loop were identified (D). An abdominal CT scan showed stomach dilation and gave the impression of thickening of the pyloric wall and superior part of duodenum (B). In addition, a distended gallbladder, a common bile duct of one cm in diameter and borderline distention of intrahepatic ducts were observed. Subsequently, a nasogastric tube was placed which drained 2 litres of food containing liquid. Antibiotics, opioid analgesics and intravenous fluids were also given. During gastroduodenoscopy a bundle of several entangled Ascaris Lumbricoides roundworms was identified obstructing the duodenum lumen and some of them were removed endoscopically. Following albendazole treatment for three days and passing several dead worms per rectum, the patient recovered and radiological findings resolved completely.


Corresponding author:
Lykourgos Christos Alexakis, Médecins Sans Frontières, 1st Department of Internal Medicine, “G, Gennimatas” General Hospital, Athens, Greece
lchalexakis@gmail.com

©Lykourgos Christos Alexakis et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More images in clinical medicine

 
 
 
 
 
 
 
 
    






PAMJ Images in Medicine and Public Health are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 26 (Jan - Apr 2017)

This image


Share this image:

Filter images [Reset filter]

By language

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved