Ascaris on barium meal follow up

Roundworm is the common name for Ascaris lumbricoides which is the commonest helminthic infection, more common in the developing world due to various reasons such as poor personal hygiene and faecal contamination of food and soil. The prevalence in children is much higher than adults and children are more often symptomatic too[1]. Colicky abdominal pain, nausea, distension, diarrhea may be manifestations of partial or complete intestinal obstruction by this worm. A worm bolus often causes intestinal obstruction in children. Barium Meal follow up examination can demonstrate the roundworms as sharply outlined, linear or cylindrical filling defects in the barium column of the small intestine. The barium adheres to the surface of the worm so that its outline is visible. Sometimes a threadlike shadow within this indicates the presence of barium in the enteric canal of the parasite[2]. Plain radiograph of the abdomen is non specific and may show multiple fluid levels in case of obstruction[1] US Abdomen demonstrates echogenic moving linear structures within small bowel Definitive diagnosis is usually made by stool examination which will reveal ova of the worms within. It is easy, cheap n ready available. However, when the diagnosis is overlooked clinically, worms may be detected radiologically. This detection helps determine cause of abdominal symptoms in patients being treated as case of peptic ulcer disease. The detection is important because worm infestation is simple to cure and re-infestation can easily be avoided. If there is obstruction secondary to worms, unnecessary laparotomy can be avoided and medical treatment will suffice.