A Case of Curative Resection of Massive Small Bowel Gangrene at Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Abstract

Ascariasis is a helminthic infection of humans with worldwide distribution. It is estimated that more than 1.4 billion people are found infected with Ascaris lumbricordes, representing 25% of the world population. We report a case of small bowel volvulus in a 15 year old male child who presented with vague symptoms of vomiting, distension of abdomen, mild pain and constipation. It was diagnosed as a case of small bowel obstruction with the presence of a bunch of Ascaris mass lying in one of the bowel loop. Administration of albendazole therapy through nasogastric tube in initial stages helps in evacuation of worms via stool successfully. The condition of this patient did not give us space to try this regime, therefore the patient had to be submitted for emergency laparotomy, resection, anastomosis and eventually his recovery with great satisfaction. This case is unique in highlighting the efforts of surgical team for achieving success through massive surgical procedures, monitoring post operative critical course and the hospitalization period till his discharge from the surgical ward.