Clinical appraisal of Ascaris lumbricoides, with special reference to surgical complications

Over a period of 4 years (January 1993-December 1997), 509 patients were tr eated for abdominal colic with or without intestinal obstruction and a hist ory of passage of adult roundworms either in the stool or in vomitus. All p atients were below the age of 10 years, the youngest 6 months old, and were treated successfully with antispasmodics and normal saline enemas. When th e pain subsided, an anthelminthic drug was given. Of 209 patients admitted to the hospital, 105 responded to conservative management and 104 (50%) req uired surgical intervention. The procedures included squeezing out of worms , resection and anastomosis, and treatment of other pathologies like acute appendicitis, tubercular stricture of the small intenstine, etc. Five patie nts died in the postoperative period due to various complications. There we re no deaths among those treated by conservative management. Early recognit ion of the condition can prevent serious surgical complications and morbidi ty.