Large-bowel obstruction secondary to Enterobius vermicularis pseudotumour

• Published in: BMJ case reports Vol. 15; no. 11; p. e252676
• Main Authors: O'Brien, Stephen, Ahmed, Sami, Hayes, Brian, O'Riordain, Michael
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 29.11.2022
• Subjects: Abdomen; Abdominal Cavity; Animals; Appendectomy; Auscultation; Case reports; Child; Colon; Colonoscopy; Colorectal cancer; Colostomy; Constipation; Enterobiasis - complications; Enterobiasis - diagnosis; Enterobiasis - surgery; Enterobius; Hepatitis; Histology; Humans; Infections; Intestinal obstruction; Laparoscopy; Lymphatic system; Male; Medical imaging; Ostomy; Pain; Pediatrics; Pruritus; Vomiting; Worms; Gastrointestinal surgery; General surgery; Infection (gastroenterology); Hepatitis and other GI infections
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2022-252676

Enterobius vermicularis infection is typically observed in paediatric patients and manifests with perianal pruritus, but other manifestations or ectopic presentations have been reported in the literature. We present the case of a man in his 60ss with a large-bowel obstruction with symptoms including a 4-day history of progressive abdominal pain, distension, vomiting and absolute constipation. On examination, his abdomen was distended with tinkling bowel sounds on auscultation. Cross-sectional imaging demonstrated an obstructing mass in the distal descending colon. An emergency laparoscopic Hartmann's procedure was performed and the patient made an uneventful recovery. An intraoperative colonoscopy demonstrated numerous white threadworms in the colon. Histological analysis demonstrated a pseudotumour related to Enterobius vermicularis infection. This case represents a rare differential diagnosis for a large-bowel obstruction.