SURGICAL-MANAGEMENT OF WORM VOLVULUS

A retrospective study of 50 consecutive patients with small-bowel volv ulus complicating intestinal ascariasis is reported. The commonest pre senting features were abdominal distension (44 patients) and abdominal pain (38 patients). Thirty-three patients presented with vomiting, of whom 8 vomited worms. Twenty-five patients presented with peritonitis . In 33 patients there was evidence of worm infestation on radiographs while volvulus was diagnosed radiographically in 16 patients. Thirty- two patients required emergency surgery, while 16 were observed for a mean of 2.6 days before surgery. Thirty-nine patients had gangrenous b owel that required resection. The overall mortality rate was 14.5% and all deaths were from the gangrenous group. The results show that volv ulus complicating ascariasis still carries a high mortality and morbid ity rate. We stress the importance of early detection and early operat ive intervention.