PARASITIC INFESTATIONS

SURGICAL INTERVENTION

Abstract

Parasitic infections lead to burden of morbidity and mortality in developing
countries. Surgeons practicing in the tropics are familiar with the parasitic disorders. Objectives:
To determine the role of surgery in parasitic infestations of Echinococcus granulosus and Ascaris
lumbricoides. Design: Cross sectional case series study. Period: Two years. Setting: Liaquat
University Hospital Hyderabad. Patients and methods: All the patients with Echinococcus
granulosus and Ascaris lumbricoides were admitted in the ward and were observed for different
manifestations and surgical procedures aimed to cure the echinococcosis and ascariasis
infestation. The data was analyzed in SPSS 16 and the frequency and percentage was
calculated. Results: During two years study period, total sixty cases of parasitic infestations
(50 cases of Echinococcus granulosis and 10 cases of Ascaris Lumbricoides) were detected
at Liaquat University Hospital Hyderabad / Jamshoro. The hydatid cysts was more common in
the age group of 30-39 years while the mean age ± SD in overall patients with Echinococcus
granulosis infestation was 38.74±7.84 whereas it was 35.87±8.64 and 40.43±6.73 in male and
female population respectively. The Ascaris Lumbricoides was more common in the age group
of 15-20 years while the mean age ± SD in overall patients with Ascaris lumbricoides infestation
was 16.62±5.21 whereas it was 15.42±7.31 and 16.43±5.41 in male and female population
respectively. Among 47 surgically treated cases of echinococcus, the approach used were
cyst evacuation and tube drainage in 40 patients, total cystopericystectomy in 04 patients and
laparoscopically in 03 subjects accordingly. Seven (70%) cases of intestinal obstruction due
to ascariasis underwent surgical intervention like external milking of the obstructing bolus of
worms from the ileum into colon in 03 patients, intestinal resection and end to end anastomosis
in 01 case and enterotomy and manual extraction of worms in 03 subjects accordingly.
Conclusions: Hydatid disease and Ascaris lumbricoides may cause fatal complications and
surgical intervention has been the valuable option.