Ascariasis Presenting as Hematoma in the Sigmoid Mesocolon: A Case Report

• Published in: Journal of the Korean Society of Radiology Vol. 81; no. 4; pp. 1013 - 1018
• Main Authors: Kim, Ji-Eun, Bae, Kyung Eun, Kim, Hyun-Jung, Bae, Byung-Noe, Lee, Ji Hae, Kang, Mi-Jin, Kim, Ji-Young, Kim, Jae Hyung
• Format: Journal Article
• Language: English
• Published: The Korean Society of Radiology 01.07.2020; 대한영상의학회
• Subjects: Abdominal Imaging; ascariasis; bowel perforation; hematoma; sigmoid mesocolon; 방사선과학
• ISSN: 1738-2637; 2288-2928; 2951-0805
• DOI: 10.3348/jksr.2020.81.4.1013

Ascariasis is an intestinal disease caused by Ascaris lumbricoides . Most patients with ascariasis are asymptomatic; however, the presence of many larvae in the bowel can cause gastrointestinal complications, such as intestinal obstruction, obstructive jaundice, cholangitis, cholecystitis, and pancreatitis. Herein, we report a case of ascariasis presenting as hematoma and active bleeding in the sigmoid mesocolon of a 74-year-old man on computed tomography (CT). Sigmoid colon perforation was also detected on follow-up CT. Laparoscopic low anterior resection was performed; there was a large hematoma in the sigmoid mesocolon. Roundworms were microscopically identified in the mesenteric adipose tissue. The clinical and CT findings of this unusual presentation of ascariasis revealed serial complications during parasite migration from the intestinal lumen to the peritoneal cavity.