SURGICAL COMPLICATIONS OF ASCARIASIS

Over the past 25 years (1963-1988), a total of 311 children under 12 years of age were admitted to the Pediatric Surgical Service of the San Vicente de Paul University Hospital, Medellin, Colombia, with complications resulting from infection with Entamoeba histolytica or Ascaris lumbricoides. In this group, the abdominal complications produced by ascariasis numbered 145, and included intestinal obstruction (n = 107), perforation of the appendix (n = 10), and migration of the parasite to the biliary tree or to the peritoneal cavity (n = 28). Evaluation of the living conditions of a significant subgroup of our patients confirms that intestinal parasitism is an endemic condition prevailing in nations that exhibit deep social and economic imbalance, where large sectors of the population remain deprived of the basic services of education, health, housing, and recreation. Massive infestation in children may give rise to grave complications that demand expert surgical care. Third World surgeons practicing in general hospitals that take care of patients of low economic capacity are usually familiar with the diagnosis and management of this pathology; surgeons who practice in the industrialized nations will only occasionally face such problems. The greater mobility of today's societies and the rather massive migrations that take place in current times have resulted in an increasing incidence of these entities in the hospital populations of the large urban centers of these nations. It is for the surgeons practicing in such centers that the information presented herein may be of greater value.