Paediatric Radiology

An 11-year-old girl presents with acute pain in abdomen of 12 hours duration. An ultrasound of the abdomen and pelvis is asked for.
What is the diagnosis ?

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USG shows a linear echogenic shadow floating in free fluid in the lower abdomen. A few scattered dilated bowel loops were noted in the pelvis.

Diagnosis

Roundworm perforation leading to peritonitis

Discussion

Operative laparotomy of this patient revealed presence of 3 roundworms in the peritoneal cavity with fecal peritonitis.

Ascaris lumbricoides is the commonest parasitic infestation in the world even today.

It usually resides in the small bowel, and is known to cause complications due to migration into the biliary tract, or lungs. Perforation through the small bowel leading to peritonitis is a common mode of presentation.

Ultrasound features of roundworms include a linear, echogenic stripe or parallel echogenic lines with central lucency representing the digestive tract of the worm.

Contribution

Dr. Sanjeev Mani, Mumbai

Email: smani@bom2.vsnl.net.in