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PubMedDate not supplied

Biliary Ascariasis in children.

BACKGROUND: Ascariasis is very common in this part of the world. Biliary Ascariasis is rare but is the commonest extra-intestinal complication. METHODS: This study was conducted At Ayub Teaching Hospital, Abbottabad, a tertiary care hospital. Five cases of biliary Ascariasis were studied from December 1999 to January 2001. History of passage of worms in stool or vomiting and abdominal pain was taken. After clinical evaluation, Stool Examination, Serum amylase, LFTs, and complete blood picture (CP) were done. Ultrasound abdomen was done as a basic tool for diagnosis. All cases were given Piperazine. Spasmolytics were also given to relax sphincter of oddi to release the worms. Surgical opinions were also taken for each case. RESULTS: About 80% Children were above 10 years of age. One case was 1 1/2 years old. Most common symptom was right upper quadrant abdominal pain. Previous history of passage of worms in stool and vomitus was also present. Two children developed complications of Biliary Ascariasis i.e., Cholecystitis and Portal empyema and responded to antibiotics. All children became symptom free in about 48 hours of treatment. Ultrasound was found to be a reliable, non-invasive, and quick tool for diagnosis and follow up.

Animals↗
PubMed2002

[Endoscopic management of biliary and pancreatic ascariasis in Viet-Nam. Report of a series of 91 cases].

AIM: Ascariasis is the most widespread helminthiasis in the world. Biliary and pancreatic involvement, frequently encountered in endemic areas, is a serious public health problem. Surgical management is often required. The purpose of our work was to assess the feasibility of emergency endoscopic treatment of biliary and pancreatic ascariasis in the Viet Duc hospital (Hanoi, Vietnam), and to evaluate outcome. METHODS: A prospective study conducted over a 3-year period included 91 patients with biliary and pancreatic ascariasis. Diagnosis was based on clinical findings and abdominal ultrasound and was confirmed by endoscopic procedures. RESULTS: The 91 patients, 21 males and 70 females, mean age 41 +/- 17 years, underwent endoscopic procedures to retrieve the worm. The procedure was successful in 89 patients (97.8%). Mild pancreatitis occurred in four patients who underwent biliary sphincterotomy. The mean hospital stay was 3.1 days. CONCLUSION: Endoscopic management of ascariasis is feasible, with a very low morbidity and a high rate of success. With this treatment, hospital stay is greatly shortened.

Adolescent↗
PubMed1991

Effects of improved water supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma.

A total of 144 studies were analysed to examine the impact of improved water supply and sanitation facilities on ascariasis, diarrhoea, dracunculiasis, hookworm infection, schistosomiasis, and trachoma. These diseases were selected because they are widespread and illustrate the variety of mechanisms through which improved water and sanitation can protect people. Disease-specific median reduction levels were calculated for all studies, and separately for the more methodologically rigorous ones. For the latter studies, the median reduction in morbidity for diarrhoea, trachoma, and ascariasis induced by water supplies and/or sanitation was 26%, 27%, and 29%, respectively; the median reduction for schistosomiasis and dracunculiasis was higher, at 77% and 78%, respectively. All studies of hookworm infection were flawed apart from one, which reported a 4% reduction in incidence. For hookworm infection, ascariasis, and schistosomiasis, the reduction in disease severity, as measured in egg counts, was greater than that in incidence or prevalence. Child mortality fell by 55%, which suggests that water and sanitation have a substantial impact on child survival. Water for personal and domestic hygiene was important in reducing the rates of ascariasis, diarrhoea, schistosomiasis, and trachoma. Sanitation facilities decreased diarrhoea morbidity and mortality and the severity of hookworm infection. Better water quality reduced the incidence of dracunculiasis, but its role in diarrhoeal disease control was less important than that of sanitation and hygiene.

Ascariasis↗
PubMed1986

Endoscopic treatment of ascariasis causing acute obstructive cholangitis.

Ascariasis lumbricoides is one of the most common helminthic infections in developing countries. Biliary ascariasis presents with recurrent cholangitis and sometimes with liver abscesses. We report the case of a young Philippino worker in Saudi Arabia who presented with obstructive jaundice, cholangitis and liver abscesses secondary to biliary tract ascariasis. The diagnosis was made at endoscopic retrograde cholangio-pancreatography (ERCP) and the obstructing worms were removed with a Dormia basket after endoscopic sphincterotomy at this procedure. Full resolution of the biliary and hepatic sepsis followed. Urgent ERCP and endoscopic decompression of the biliary system in biliary ascariasis is recommended.

Adult↗
PubMedDate not supplied

Hypertonic saline enema in gastrointestinal ascariasis.

Many dangerous surgical complications like intestinal obstruction, acute appendicitis with perforation, ileal perforation in a typhoid patient, Meckel's diverticulitis, disruption of post operative intestinal anastomosis, volvulus, and intussusception are known to occur due to ascariasis, with considerable morbidity and mortality. In this retrospective study of 250 cases of gastrointestinal ascariasis admitted in paediatric surgical wards of Govt. Medical College, Jabalpur (MP), the authors analysed the results of conservative (especially the use of hypertonic saline enema-given just like an ordinary soap water enema but substituting freshly made hypertonic saline in place of soap water) and surgical treatment. The success rate of conservative treatment was 95.6%. Hypertonic saline passes through the incompetent ileo-caecal valve (present in 80% of children) and irritates the worm bolus commonly situated in the terminal ileum, causing it to disintegrate. It also helps to increase the intestinal motility and passage of worms into the colon. The use of hypertonic saline enema is safe and effective in the conservative treatment of gastrointestinal ascariasis. Authors feel that it is the most grossly under utilized part of conservative treatment and deserves to be known and used on wider scale.

Adolescent↗
PubMed1988

The influence of ethnicity, an atopic family history, and maternal ascariasis on cord blood serum IgE concentrations.

Raised concentrations of cord blood serum (CBs) IgE have previously been demonstrated to reflect a hereditary predisposition for atopy in First World, predominantly white populations. A cross-sectional study of 53 black, 52 white, and 58 mixed race newborn infants and maternal pairs was performed in a multiethnic, mixed First and Third World society. The CBs IgE concentrations were measured with a modification of the standard IgE PRIST, which could reliably determine IgE concentrations to an accuracy of 0.01 kU/L. The black group had the highest geometric mean and median CBs IgE concentrations (0.21; 0.16 kU/L), followed by the white group (0.12; 0.12 kU/L) and the mixed group (0.10; 0.08 kU/L). If those newborn infants with an atopic family history and maternal ascariasis were excluded, the remainder had geometric mean and median CBs IgE concentrations of 0.20; 0.16 kU/L in the black subgroup, followed by values of 0.06; 0.05 kU/L in the mixed subgroup, and 0.05; 0.07 kU/L in the white subgroup. Statistically significant ethnic differences in the median CBs IgE concentrations of these subgroups were demonstrated between the black-white (p less than 0.05) and the black-mixed (p less than 0.005) ethnic groups. A positive family history of atopy influenced the CBs IgE concentrations in the white and mixed groups but not in the black group. Of those newborn infants with a CBs IgE concentration greater than 0.5 kU/L, a family history of atopy was found in 100% of the white newborn infants, in 58.3% of the mixed newborn infants, and only in 14.3% of the black newborn infants. Many of the black newborn infants without a family history of atopy had extremely high CBs IgE concentrations. The influence of maternal ascariasis was equivocal in the mixed group but of no significance in the black group. The high CBs IgE concentrations in the black newborn infants, independent of an atopic family history and maternal ascariasis, suggest that this atopic marker may therefore be of limited use in identifying the "high allergic-risk" newborn infant in black Third World populations who appear to represent a pool of genetic high IgE-responder phenotypes.

Ascariasis↗
PubMed2001

Ultrasonographic features of pseudotumorous form of ascariasis.

We report the ultrasonographic findings of a 60 year old woman with pseudotumorous form of ascariasis. Real-time ultrasonographic examination using a curved array transducer revealed grossly thickened small bowel loops, multiple small circular deposits throughout the peritoneal cavity, and a moderate amount of ascites. The English literature on the different forms of abdominal ascariasis is reviewed. Specific signs, which include the 'strip' sign, the 'four-lines', 'inner tube', or 'double tube' sign, the 'bull's eye' or 'target' sign, a 'worm mass' or 'spaghetti-like' appearance, and the 'zig-zag' sign can be present in any form of abdominal ascariasis, as they represent the image of the Ascaris worms visualized under ultrasonographic examination. However, the non-specific signs are not peculiar to A. lumbricoides infections, but are results of secondary changes due to A. lumbricoides infections in the corresponding organs.

Animals↗
PubMed1996

Ascariasis.

Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing countries. Ascaris-related clinical disease is restricted to subjects with heavy worm load, and an estimated 1.2 to 2 million such cases, with 20,000 deaths, occur in endemic areas per year. More often, recurring moderate infections cause stunting of linear growth, cause reduced cognitive function, and contribute to existing malnutrition in children in endemic areas. Ascaris infection is acquired by the ingestion of the embryonated eggs. The larvae, while passing through the pulmonary migration phase for maturation, cause ascaris pneumonia. Intestinal ascaris is usually detected as an incidental finding. Ascaris-induced intestinal obstruction is a frequent complication in children with heavy worm loads. It can be complicated by intussusception, perforation, and gangrene of the bowel. Acute appendicitis and appendicular perforation can occur as a result of worms entering the appendix. HPA is a frequent cause of biliary and pancreatic disease in endemic areas. It occurs in adult women and can cause biliary colic, acute cholecystitis, acute cholangitis, acute pancreatitis, and hepatic abscess. RPC causing hepatic duct calculi is possibly an aftermath of recurrent biliary invasion in such areas. Ultrasonography can detect worms in the biliary tract and pancreas and is a useful noninvasive technique for diagnosis and follow-up of such patients. ERCP can help diagnose biliary and pancreatic ascariasis, including ascaris in the duodenum. Also, ERCP can be used to extract worms from the biliary and pancreatic ducts when indicated. Pyrantel pomoate, mebendazole, albendazole, and levamisole are effective drugs and can be used for mass therapy to control ascariasis in endemic areas.

Adult↗
PubMed1996

Endoscopic treatment of biliary ascariasis. Report of a case.

Ascaris lumbricoides is the most common intestinal parasite to infect humans. The incidence of ascariasis is increasing in our regions, due to world travel and population migration. In one third of cases, the worm can enter the bile duct and cause cholangitis or biliary colics. Diagnosis and treatment of ascariasis are discussed. Endoscopic retrograde cholangio-pancreaticography (ERCP) with endoscopic extraction of the worm, using a Dormia basket, is a safe and effective procedure for the diagnosis and treatment of biliary ascariasis. This technique serves as an effective alternative for surgery.

Animals↗
PubMed1976

Vitamin A absorption in ascariasis.

Vitamin A absorption was studied in a group of 28 adult patients with ascariasis and 12 healthy adult controls, using a simplified vitamin A absorption test. In over 70% of the patients with ascariasis malabsorption of vitamin A was demonstrated. Stool egg counts for ascaris were not related to the degree of vitamin A malabsorption. Of the 23 patients in whom a D-xylose absorption test was performed, seven showed excretion less than 20% in 5 hr. Immediately after expulsion of the worms, vitamin A absorption improved in 13 out of 14 patients tested (in nine to normal level). The results of this study suggest that ascariasis in populations on marginal intakes of vitamin A and its precursors is an important contributing factor in producing clinical vitamin A deficiency.

Adolescent↗
PubMed1979

Malabsorption of water miscible vitamin A in children with giardiasis and ascariasis.

Vitamin A absorption was studied using a water-miscible oral preparation of vitamin A in 19 children ages 1 1/2 to 9 years old with giardiasis and/or ascariasis, both before and after their eradication with appropriate therapy, and in three children without parasites. Marked impairment of vitamin A absorption was noted when administered in a water miscible form in children with 1) combined infection with Giardia lamblia and Ascaris lumbricoides, 2) giardiasis alone, and 3) in a proportion of children with ascariasis alone. In children with both giardiasis and ascarasis eradication of the infections promptly lead to a significant improvement in vitamin A absorption and restored it to normal. Children with giardiasis alone also showed improved vitamin A absorption after therapy. In children with ascariasis alone successful therpay did not lead to a statistically significant improvement.

Ascariasis↗
PubMed1979

Ascariasis and malnutrition. A study in urban Ethiopian children.

Treatment of 13 urban Ethiopian children with mild ascariasis did not produce any evidence of improved intestinal morphology and absorption or nutritional status. Ascariasis treatment had no impact on anthropometric measures in an additional study group of 84 children. A review of the literature reveals that the nutritional consequences of ascariasis are uncertain.

Anthropometry↗
PubMed1998

Biliary ascariasis complicating endoscopic sphincterotomy for choledocholithiasis in India.

Endoscopic sphincterotomy is the treatment of choice for patients with choledocholithiasis. Biliary ascariasis has been reported from many parts of the world but is common in Kashmir, India. We report five cases of biliary ascariasis of which four were the result of post-endoscopic sphincterotomy for choledocholithiasis. Therefore, biliary ascariasis is not an uncommon complication of endoscopic sphincterotomy.

Ascariasis↗
PubMed1997

Surgical ascariasis in children in Kashmir.

A retrospective study of 85 children aged 3-12 years revealed 25 cases who needed surgical intervention due to ascariasis. The surgical conditions found at laparotomy were intestinal obstruction (18) appendicitis (3), ileal perforation (2), biliary ascariasis (2). The study highlights the high incidence of surgical ascariasis among children with abdominal complaints in an endemic area.

Animals↗
PubMed2004

Comparative efficacy of albendazole and three brands of mebendazole in the treatment of ascariasis and trichuriasis.

OBJECTIVE: To evaluate the comparative efficacy of 400 mg albendazole (Smith Kline Beecham) as a single dose and three brands of mebendazole (Janssen, Unibios and East African Pharmaceuticals) at doses of 100 mg twice a day for three consecutive days in the treatment of single or mixed infections with Ascaris lumbricoides and or Trichuris trichiura in four treatment groups of school children. DESIGN: Randomized trial. SETTING: Wondo-Genet, southern Ethiopia. SUBJECTS: School children, aged six to nineteen years. RESULTS: The percentage cure rate and egg reduction rate obtained with albendazole and mebendazole from the three brands were not significantly different in the treatment of ascariasis. However, significant differences were found among the percentage cure rates and egg reduction rates of the four treatment groups in the treatment of trichuriasis. Comparatively, high cure rate (89.8%) and egg reduction rate (99.1%) were observed in vermox (Janssen) treated group followed by Unibios (India) treated group (53.3% and 96.53% cure and egg reduction rates, respectively), whereas low cure rate (17.1%) and egg reduction rate (69.8%) were seen in the albendazole treated group. CONCLUSION: The results of this study suggest that in areas of single or mixed infections with Trichuris trichiura and/or Ascaris lumbricoides are common public health problems and where laboratory facilities are not available to make parasite identification, mebendazole (particularly vermox, a product of Janssen laboratory) would be the drug of choice to treat trichuriasis and ascariasis. However, either mebendazole from the different brands or albendazole is effective in the treatment of ascariasis in areas where trichuriasis is not prevalent.

Adolescent↗
PubMed1988

[Three recent cases of ascariasis in northern Kyushu].

Ascariasis is considered to be one of the rare infectious diseases in Japan, but recently it has been slightly increasing. This paper reports three ascariasis cases who seemed to be infected recently in the Kitakyushu area, Japan. Case 1: A 59-year-old woman in Kitakyushu City passed a round worm after continuous abdominal pain. The patient was discharged from the hospital because of no further abnormal intestinal symptoms and findings. Case 2: An 85-year-old woman in Nakama City, who suffered from cerebral infarction, vomited a round worm before hospitalization. Many ascarid eggs were detected after admission, and after treatment with pyrantel pamoate (Combantrin) two round worms were passed and egg detection became negative. Case 3: A 77-year-old man in Saikawa Town vomited 3 round worms after gastrectomy due to early gastric cancer. Many unfertilized eggs were also detected from the stool together with hook worm eggs, but no eggs were found after administration of pyrantel pamoate. Morphological examination was made by a scanning electron microscope on the denticles on the dentigerous lip ridges of the worms to differentiate from possible infection with a pig parasite, Ascaris suum. The three cases were diagnosed as ascariasis due to human Ascaris lumbricoides based on the following evidences that the expelled worms had 1) less pointed tips of the denticles and shallower or wider interdenticle notches, and 2) far more denticles of smaller size along the dentigerous ridges, compared with Ascaris suum. The necessity of differentiating pig- from human-ascarids, when considering human infection with Ascaris suum, is discussed.

Aged↗
PubMed2000

Laparoscopic treatment for biliary ascariasis.

Biliary ascariasis is one of the most common types of ascaris infections. The current treatments are helminthic drug therapy, endoscopic extraction, and surgical extraction. A case of biliary ascariasis and cholecystocholedocholithiasis was successfully treated by laparoscopic extraction of the living worm and biliary stones. This procedure was found to be very effective for biliary ascariasis with biliary stones, and it holds promise for similar cases in the future.

Ascariasis↗
PubMed2001

Hepatobiliary and pancreatic ascariasis.

Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Asia and Latin America. Of 4 million people infected in the United States, a large percentage are immigrants from developing countries. Ascaris-related clinical disease is restricted to subjects with heavy worm load, and an estimated 1.2 to 2 million such cases, with 20,000 deaths, occur in endemic areas per year. More often, recurring moderate infections cause stunting of linear growth, cause reduced cognitive function, and contribute to existing malnutrition in children in endemic areas. HPA is a frequent cause of biliary and pancreatic disease in endemic areas. It occurs in adult women and can cause biliary colic, acute cholecystitis, acute cholangitis, acute pancreatitis, and hepatic abscess. RPC causing hepatic duct calculi is possibly an aftermath of recurrent biliary invasion in such areas. Ultrasonography can detect worms in the biliary tract and pancreas and is a useful noninvasive technique for diagnosis and follow-up of such patients. ERCP can help diagnose biliary and pancreatic ascariasis, including ascaris in the duodenum. Also, ERCP can be used to extract worms from the biliary and pancreatic ducts when indicated. Pyrantel pamoate, mebendazole, albendazole and levamisole are effective drugs and can be used for mass therapy to control ascariasis in endemic areas.

Ascariasis↗