Diferencias clínicas entre oclusión y suboclusión intestinal por Ascaris lumbricoides. Datos que orientan al tratamiento quirúrgico

Abstract

Introduction. Ascariasis is a public health problem in our country. One of its complications is intestinal obstruction with either intestinal suboclussion or occlusion. The latter necessitates surgical treatment. Goal. To identify the preoperative clinic differences in patients with intestinal suboclussion or occlusion caused by Ascaris in order to determine what factors justify a surgical treatment for intestinal occlusion. Methods. Retrospective study from 1999 to 2009 in the Hospital del Nino “Dr. Rodolfo Nieto Padron” in 50 patients with intestinal suboclussion and 50 with intestinal occlusion. Preoperative clinical data were analyzed, with SPSS 13.0 version, and the statistic significance with square Chi was determined. Results. Children under five years of age were the most frequently affected. The significant statistic preoperative clinical features (symptoms, signs and laboratory findings) between occlusion and suboclusion by Ascaris were fever, abdominal distension, vomit; hemoglobine less than 10 grams and a history of antiparasitic therapy (mebensole) with a p=0.006. Discussion. Based on this data, a clinical model could predict that children under five years of age, with anemia, abdominal distention, vomit, fever and previous antiparasitic therapy (mebensole), may have occlusion by Ascaris lumbricoides and the need of surgical treatment before clinical features of acute abdomen set in.