Case Report

Intermittent Obstruction of Jejunostomy Tube Due to Ascaris lumbricoides Infection

Authors: Camron Kiafar, DO, Deepa Shah, MD, Darrell Wadas, MD, Nooman Gilani, MD, FACG

Abstract

A 45-year-old Costa Rican woman was seen for a jejunostomy tube malfunction. There was no evidence of tube malposition or intestinal obstruction. During endoscopy, a long worm was retrieved from the distal duodenum; it was later confirmed to be Ascaris lumbricoides. After treatment with mebendazole, no further episodes of tube occlusion were observed. This case reminds us of the importance of considering helminthic infections and their atypical manifestations in patients from endemic regions.


Key Points


* Ascaris lumbricoides is one of the most common human helminthic infections.


* Ascaris is thought to be the leading cause of Loeffler syndrome worldwide.


* Luminal obstruction, including intestinal and biliary or pancreatic ducts, are among the most common gastrointestinal complications.


* Stool microscopy, blood eosinophil counts, and abdominal ultrasound are the most useful initial diagnostic tools, and benzimidazoles are the first line of treatment.


* In Western countries, atypical manifestations of this infection should be considered in immigrants and travelers from endemic areas.

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