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Ascaris Lumbricoides worm encountered in the stomach

Mohamed Aly Mokhles

National Research Center .Egypt

Ascaris is a neglected tropical disease that causes annual death of about 60000 cases . As shown in figure 1 , infection starts when the host ingests stool contaminated soil harboring the eggs , thereafter they are released from the duodenum as larvae to enter the circulation via enteric mucosa to reach the liver via the portal vein , then the lungs within the first week to be expectorated and reenter the gastrointestinal tract where they mature to adult worms where the male and female worms copulate to produce enormous amount of eggs reaching up to 200000 eggs per day to pass with feces to the soil.

Ascaris infestation show quite a wide array of clinical manifestations as it maybe asymptomatic showing only long term manifestations of growth retardation and malnutrition , or may show early pulmonary symptoms coinciding with the initial lung migration in the first 10-14 days after ingestion, as cough, dyspnea, wheezing, urticaria, hemoptysis, and chest pain or may show a clinical picture of partial or complete intestinal obstruction by adult worms as abdominal pain, distension, colic, nausea, anorexia, and vomiting , moreover , jaundice, nausea, vomiting, fever, and severe or radiating abdominal pain may suggest cholangitis, pancreatitis, hepatic abscess, or appendicitis.

  • Jourdan PM, Lamberton PHL, Fenwick A, Addiss DG. Soil-transmitted helminth infections. Lancet. 2018 Jan 20;391(10117):252-265. doi: 10.1016/S0140-6736(17)31930-X. Epub 2017 Sep 4. PMID: 28882382.
  • Fahim SM, Das S, Gazi MA, Mahfuz M, Ahmed T. Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum-dwelling children in the first 2 years of life in Bangladesh. Trop Med Int Health. 2018 Nov;23(11):1242-1250. [PMC free article] [PubMed]
  • Sharma M, Somani P, Prasad R, Jindal S, Pathak A. Biliary ascariasis: mimicker of biliary stent. VideoGIE. 2017 Jul;2(7):179-181. [PMC free article] [PubMed]
  • David R Haburchak Ascariasis Medscape 2018
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Ascaris adult worm in the stomach
Ascaris adult worm in the stomach
Ascaris worm after retrieval

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