Page 254 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-003
Intestinal Obstruction Caused by Ascaris Lumbricoides:
A Case Report from an Endemic Area in North Kalimantan

Lili Widianto, Sayyidah Auliany, Dwi Sapriyantina, Dian Artanti
Department of Child Health, North Kalimantan General Hospital, Tarakan, North Borneo, Indoesia

Abstract
Background The international community has pledged through the Sustainable Development Goals (SDGs)
to eliminate ascariasis as one of neglected tropical diseases. Ascariasis caused by Ascaris lumbricoides
infestation in human. When symptoms do occur, they relate to the larval life cycle. Heavy worm burden (>60)
can lead to Intestinal obstruction. Objective To demonstrate successful conservative management on intestinal
obstruction caused by ascariasis in pediatric case. Case A 2-year-old-girl admitted to emergency department
with abdominal pain and chronic constipation lasting for 1 month. She had coughed and defecated worm 1
year ago. They live in Pantai Amal, North Kalimantan, where ascariasis are common in local child. There
was history of ascariasis in her brother and neighbors. Risk factor in this case are contaminant environmental
(shared toilet and water sources), raw food consumption, non-compliance to mass drug administration
programmes in Posyandu. The child weighed 10 kg, 87 cm in height, BMI: 12.4 (underweight). Physical
examination revealed pallor conjunctiva, distended abdominal (49 cm) with hyperactive bowel sounds, and
periumbilical pain without peritoneal sign. Laboratory finding include: 1) Complete blood count: Hb:9.8 gr/
dL, MCV:69.3 fL, MCHC:34.7 g/L, WBC:57.200/uL, Eosinofilia: 76.2%, 2) Ascaris lumbricoides’s eggs and
larval in fecal analysis, 3) Normal abdominal and chest radiography. She was managed conservatively with
nil by mouth, intravenous fluid, nasogastric tube, albendazole and pyrantel pamoat, antibiotics and glycerin
per rectal. Symptoms relieved in the 7 day. Conclusion Conservative management is the first-line therapy
th
in Intestinal obstruction without peritonitis sign due to ascariasis.
Keywords: ascariasis; intestinal obstruction; conservative management

206 KONIKA XVIII Abstract Book