Complex intestinal ascariasis with secondary peritoneal obstruction and irritation. Report of a case

Abstract

Roundworm (Ascaris lumbricoides) is a nematode known in Latin America as the roundworm. It belongs to the group of parasites transmitted through contact with contaminated soil and is the most common helminthiasis worldwide, especially in children aged 2 to 10 years. In Paraguay, the prevalence of intestinal parasitosis in school-aged children is high, mainly due to poor sanitary conditions and adverse socioeconomic factors. In this context, we present the case of a 3-year-old female patient, a resident of a rural area, who presented with severe abdominal pain, vomiting, fever, and abdominal distension. The physical examination revealed signs of peritoneal irritation, and stool examination confirmed the presence of Ascaris lumbricoides eggs. Imaging studies showed intestinal obstruction and abundant worms in the small intestine. Due to the severity of the condition, emergency surgery was performed, removing the parasites and performing peritoneal lavage. The patient made a favorable outcome after treatment. This case highlights the importance of timely diagnosis and comprehensive management of ascariasis complications, as well as the need to strengthen prevention strategies, health education, and access to treatment in vulnerable communities to reduce the incidence and complications associated with this parasitic infection.