Affiliation:
1. Hospital Universitario Ramón y Cajal
Abstract
Abstract
Introduction
All organs of any organism can be affected by helminths. They can be seen in a broad spectrum, from simple infestations to extensive, life-threatening involvement. Symptomatology is usually of chronic latent course. However, sometimes the presentation is acute and requires urgent surgical intervention.
Material and methods
We conducted a retrospective observational prospective recruitment study of patients undergoing emergency surgery for helminth infection from January 2000 to December 2019 at a university hospital. Sociodemographic and analytical variables, variables related to the clinical process, and the diagnostic test were analysed. Variables related to the surgical procedure and postoperative complications were also analysed.
Results
A total of 36 patients required emergency surgery for their helminth infection, which represented 0.26% of emergency abdominal surgeries. The mean age was 34.91 ± 21.5 years, with a predominance of men (69.4%). Most patients presented with pain in the right iliac fossa (69.4%), followed by symptoms compatible with intestinal obstruction (19.4%). The most frequent surgical interventions were appendectomy (38,9%) followed bowel resection (33,3%) and ileocecal resection (11,1%). Enterobious vermicularis and Anisakis simplex both together accounted for 75% of the sample. Statistically significant differences were identified in age (p<0.001), diagnostic test performed (p=0.032), intraoperative clinical diagnosis (p=0.005) and surgical treatment received (p<0.001).
Conclusion
The prevalence of emergency surgeries for intestinal helminth parasitism is decreasing. However, the majority of these are E. vermicularis and Anisakis simplex, which have distinctly different clinical presentations. Identification and recognition by surgeons continue to be necessary for further postoperative management and possible complications.
Publisher
Research Square Platform LLC
Reference22 articles.
1. Unusual histopathological findings in appendectomy specimens: a retrospective analysis and literature review;Akbulut S;World Journal of Gastroenterology,2011
2. International Journal of Infectious Diseases Anisakis, just think about it in an emergency !;Bucci C;International Journal of Infectious Diseases,2013
3. Hepatic and biliary ascariasis;Das AK;Journal of Global Infectious Diseases,2014
4. Unexpected findings in the routine histopathological examinations of appendectomy specimens A retrospective analysis of 1,970 patients;Dincel O;Annali Italiani Di Chirurgia,2017
5. Dunphy, L., Clark, Z., & Raja, M. H. (2017). Enterobius vermicularis (pinworm) infestation in a child presenting with symptoms of acute appendicitis: a wriggly tale! BMJ Case Reports, 2017. https://doi.org/10.1136/bcr-2017-220473