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Ascariasis


General Considerations

 

  • Most common parasitic infestation in the world

  • Most common in children ages 1 to 10 years

  • Most often found in distal small bowel

  • Life cycle

    • Infection is through contaminated soil

    • Involves GI tract of host twice

      • First time as egg

    • Migrates through lungs

    • Adult travels up trachea

      • Returns to GI tract for maturation (2 months)  

  • Signs and Symptoms  

    • Colicky pain

    • Hematemesis

    • Eosinophilia  

  • Imaging findings  
    • Long, tubular filling defects, especially in distal small bowel

    • The worm ingests barium and the barium may be seen as a thin line of contrast in the center of the worm

      • Especially after the remainder of the barium exits the small bowel.  See below (streak of barium in LUQ):

The worm ingests barium and the barium may be seen as a thin line of contrast in the center of the worm (red arrows)

    • Ball of worms
       

  • Complications

    • Appendicitis

    • Jaundice (if bile ducts are involved)

    • Pneumonia

    • Bowel perforation

    • Mechanical obstruction