In a rare case, a team of doctors at Delhi-based hospital recently removed 14 live round worms measuring 15 to 20 cm each, from a 38-year-old patient Sunita’s bile duct. All the worms were successfully removed endoscopically without surgery.
Sunita had been complaining of severe abdominal pain, fever, vomiting and intermittent episodes of jaundice for the past six months. The patient was advised to undergo an abdominal CT scan which 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 measuring 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 number of cases related to worms as deworming 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 14 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 diagnosed, all the round worms were endoscopically removed in a single session. Immediately after the removal, the patient was pain-free.
A relieved Sunita said: “I was suffering from abdominal pain for the last six months. Every time I visited a doctor, I was prescribed antibiotics for pain but nothing helped. With time, I couldn’t digest food and vomited at least three to four times a week. I continuously suffered from jaundice as well. A month back, my pain started to worsen and I could hardly eat anything. When I came to the hospital, 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 kg in a span of a month. Thankfully, the doctors were able to diagnose my condition. After the surgery I am completely pain free, recovering fast and feeling much better now.”
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 rural areas with poor sanitation and where contaminated soil is used as a fertiliser for fruits and vegetables.