ACUTE INTESTINAL OBSTRUCTION IN CHILDREN DUE TO ROUND WORMs.

Abstract

Objective: To know about the various presentations and management of acute intestinal obstruction due toworms in children.Design:An observational studyPlace and duration of study: This study was conducted at the saidu teaching hospital Swat, from Jan 2010to December 2010.Material and method: Total 118 children were included in the study. The necessary work up was carriedout. 68 children (patients) were treated conservatively. 50 Patients were operated upon as there was noimprovement with conservative treatment.Result: 118 children were studied, 70 male 48 female (ratio of 1.4:1). Abdominal pain was the leadingsymptom in all patients. 108 patients (91%) presented with abdominal distention. Vomiting present in 88patients (74%). History of worms pass per rectally or in vomits in 99 patients (84%). 73 patients (62%)presented with absolute constipation. 54 patients (45%) attend the OPD with pain in right iliac fossa. 03(2%)patients presented with jaundice. Low hemoglobin level was observed in 89(75%) patients, deranged LFTsin 03(2%), air fluid levels in 91 (77%) patients on abdominal X-Rays, abdominal ultrasound finding weresuggestive of acute intestinal obstruction in 77(65%) patients. All patients were treated conservatively, bykeeping nil per oral, nasogastric decompression, IV antibiotics, fluids, kleen enema per rectum. 68 patient(57%) improved with conservative treatment. While surgical intervention was carried out in 50 patients(43%). Mean hospital stay for conservatively treated patients were four days, while for surgically treatedpatients it ranged from 7-12 days. Morbidity were noticed in 7 operated patients (8.26%), 4 patients withparalytic ileus and 3 patients with wound infection. Three patients died among the surgically treatedpatients, mortality is 2.5% in our study.Conclusion: Acute intestinal obstruction due to round worms, can be treated conservatively but if noresponse, then surgical intervention must be planned.