Case Report
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World J Gastroenterol. Oct 14, 2014; 20(38): 14058-14062
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.14058
Intestinal ascariasis at pediatric emergency room in a developed country
Shuichiro Umetsu, Tsuyoshi Sogo, Kentaro Iwasawa, Takeo Kondo, Tomoyuki Tsunoda, Manari Oikawa-Kawamoto, Haruki Komatsu, Ayano Inui, Tomoo Fujisawa
Shuichiro Umetsu, Tsuyoshi Sogo, Kentaro Iwasawa, Takeo Kondo, Tomoyuki Tsunoda, Manari Oikawa-Kawamoto, Ayano Inui, Tomoo Fujisawa, Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital, Kanagawa 230-0012, Japan
Haruki Komatsu, Department of Pediatrics, Toho University Medical Center, Sakura Hospital, Chiba 285-8741, Japan
Author contributions: Umetsu S and Sogo T were both attending doctors and drafted the manuscript and they made equal contributions to this case report; Iwasawa K, Kondo T, Tsunoda T, and Oikawa-Kawamoto M participated in radiological and endoscopic examinations, and discussion on diagnosis and treatment; Inui A, Komatsu H and Fujisawa T supervised diagnosis and treatment; all authors read and approved the final manuscript.
Correspondence to: Tsuyoshi Sogo, MD, Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital, Shimosueyoshi 3-6-1, Tsurumi Ward, Yokohama City, Kanagawa 230-0012, Japan. so5244ibukick@kdp.biglobe.ne.jp
Telephone: +81-45-5763000 Fax: +81-45-5763525
Received: April 13, 2014
Revised: May 27, 2014
Accepted: June 25, 2014
Published online: October 14, 2014
Core Tip

Core tip: Intestinal ascariasis usually remains asymptomatic until the number of worms in the intestine considerably increases. A single worm of Ascaris can enter the ampulla of Vater and result in biliary colic. Ileus caused by a single worm is rare. Moreover, the diagnosis of intestinal ascariasis might not be considered as a cause of symptoms suggesting ileus because ascariasis is rare in developed countries. This is the report of a child who presented with bilious vomiting caused by a single worm of Ascaris lumbricoides. Pediatricians in developed country need to be aware that Ascaris infection can cause bilious vomiting.