Treating an extremely rare case, doctors removed 14 live roundworms measuring 15 to 20 cm each from the bile duct of a 38-year-old woman patient. All the worms were removed endoscopically without conducting any surgery.
A team of doctors led by Dr. Arvind Khurana, Head of Department, Gastroenterology, Fortis Hospital, Shalimar Bagh performed the daunting task of relieving patient Mrs Sunita of her six months long ordeal due to severe abdominal pain, fever, vomiting and intermittent episodes of jaundice.
An abdominal CT scan of patient revealed the presence of worms in the bile duct --the duct which connects liver and intestines. The patient then underwent an endoscopic procedure (ERCP) which revealed multiple live round worms, each worm measured nearly 15 to 20 cm. All worms were removed using snares and forceps.
While it is common to find worms in intestines, uncommonly, they are found in the bile duct. India has one of the highest numbers of cases related to worms as de worming medication is not routinely administered.
"Usually round worms are found in the intestines. Occasionally they can migrate to the bile duct causing pain, fever and jaundice. There have been cases where we have seen two or three round worms in the bile duct. However, to see fourteen worms is extremely rare. The patient had taken a second opinion at other hospitals which had misdiagnosed the condition and prescribed antibiotics for the pain. Once properly diagnosed, we managed to remove all the round worms endoscopically in a single session. Immediately after the removal the patient was pain free," said Dr. Arvind Khurana, Head of Department, Gastroenterology.
"I was suffering from abdominal pain for the last 6 months. Every time I visited a doctor, I was prescribed antibiotics to subside my pain but nothing helped. With time I could not digest any food and vomited at least three to four times in a week. I continuously suffered from jaundice as well," said Sunita.
She told that about a month back her pain started to worsen and ahe could hardly eat anything. "When I came to Fortis it had been a week since I had eaten anything. My pain was so bad that I could barely stand on my feet. I had lost over 12 kilos in a span of a month," she said.
Round worms infest in the human gut, where they feed and reproduce. The roundworm life cycle begins when the eggs from the adult worms living in the intestine are passed out with the faeces. This leads to the contamination of the soil. These infections are mostly seen in rural areas with poor sanitation and where contaminated soil is used as a fertilizer for fruits and vegetables.