Single Roundworm Causing Intestinal Obstruction: Rare Case with Diagnostic Dilemma

Abstract Ascariasis, a soil-transmitted helminth (STH) infection, is a worldwide health issue that infects poor people who lack access to clean drinking water and proper sanitation. Ascaris lumbricoides is the main species that infect humans. The intestinal obstruction is common among children and rare in adults. Early discovery of intestinal obstruction due to STH is critical to prevent severe complications. Inflammatory reaction and contraction of the small bowel (spasticity) can be due to neurotoxins secreted by roundworm and this can cause obstruction rarely. Hereby, we present a 35-year-old adult who presented to the emergency department with abdominal pain, distention, and intestinal obstruction. A CT scan of the abdomen revealed nothing specific. Intraoperatively, a small gut endoscopy revealed a roundworm, which was removed. Obstruction was due to contraction of terminal ileum due to toxins released in excreta of worm. The postoperative period was uneventful. Postoperatively, the patient was put on Antihelmenthic treatment.