a rare cause of SBO

i was reading up on small bowel obstruction (SBO) again as i went through all the upper and lower GI surgical diseases (glad i’m finally done with them). then i was flipping through Bailey and Love’s Short Practice of Surgery when i caught sight of this picture that gave me the creeps.

pparently, one of the rare causes of SBO are worms… (disturbing picture ahead…)

Ascaris lumbricoides is the largest of the common nematode (roundworm) infections of man. The white or yellow adult is 15-35 cm long and lives 10-24 months in the jejunum and middle ileum of the intestine. Each female produces 240,000 eggs per day, which are fertilized by nearby male worms. A recent study from China showed that 45% of infected persons shed only fertilized eggs, 40% shed fertilized and unfertilized eggs, and 20% shed only unfertilized eggs. Unfertilized eggs accounted for only 6-9% of eggs shed. Fertilized eggs released into favorable soil may become infectious within 5-10 days. Eggs may remain viable in soil for up to 17 months. Infection occurs through soil contamination of hands or food, ingestion, and the subsequent hatching of eggs in the small intestine. (Source: Emedicine)

Ascariasis. The roundworm Ascaris lumbricoides causes ascariasis. Worms can reach 10-30 cm in length. Clinical disease results from effects of pulmonary larval migration, intestinal obstruction, or migration through the biliary tree.

Ultrasound of abdomen reveals a nasty find to be expected for the operation later.

Ok, that is the prize jewel (pictures credit). As can be seen, there is some ischaemia of the small intestine. I hope i don’t encounter many of these cases when i become a doctor/surgeon. Seriously, this is sick. Any one of you encountered these before? Bongi? Somewhat similar to your fettucini post i reckon.