Perforación intestinal por ascaris lumbricoides

Abstract

The present degree work was about a 38 years old masculine patient who goes to the emergency service because of intense abdominal pain in right iliac fossa, a slight impact with a wood log of approximately 2cm x 8cm which was to a distance of 30cm, it happened 5 days before of his hospitalization as apparent cause. To the physical exam asthenic, sore, oriented, tachycardic, feverish. Abdomen: 1x2cm laceration, tense, aching to touch, hydro-aerial sounds diminished, peritoneal irritation signs positive, the exploratory laparotomy is realised finding: 1500 ml of intestinal fluid, fibrinopurulent membrane in the small intestine, perforation of 1cm in the antimesenteric border, to 20 cm from the ileocecal valve, presence of 1 ascaris in the abdominal cavity and 6 ascaris in ileum. After the surgery intervention, patient hemodynamically unstable, his admission to the ICU (intensive care unit) is decided, where vasoactive, antiparasitic , and antibiotic therapy are started. The patient went under surgery again 4 days after his admission, due to he presented dehiscence of aponeurosis of suture where for second time free ascaris in the cavity is found, the involved segment is dried up, and end-to-end anastomosis is realised, it is decided to start antiparasitic again. Patient with clinic evolution and with favourable confirmation laboratory examinations, the medical discharge is decided. The control by outpatient clinic afterwards one week of this intervention is realised, later twice in the next month and then once after two months of his intervention.