'Doctors in India remove 14 live roundworms from a woman’s bile duct'

'Doctors in India remove 14 live roundworms from a woman’s bile duct'

Story by Sumesh Rajan

Mumbai: May 2, 2018

n  Highest Case of Worms reported in the bile duct in India so far

n  Worms were as long as 15 to 20 centimeters each

n  Woman was presented with severe cramping in the stomach which led to the discovery of the worms

In an extremely rare case, doctors at Fortis Hospital in New Delhi, India, recently removed 14 live roundworms (measuring 15 to 20 cm each) from a 38-year-old patient’s bile duct.

But all the worms were removed endoscopically without surgery. This was performed by a team of doctors led by Dr. Arvind Khurana, Head of Department, Gastroenterology, Fortis Hospital, Shalimar Bagh.

“Sunita came to the hospital with complaints of severe abdominal pain, fever, vomiting and intermittent episodes of jaundice for the last six months. She was advised to undergo an abdominal CT scan which revealed the presence of worms in the bile duct (the duct which connects liver and intestines),” said Dr. Arvind Khurana, Head of Department, Gastroenterology, Fortis Hospital.

He added, “The patient underwent an endoscopic procedure which revealed multiple live roundworms, each worm measured nearly 15 to 20 cm. This was a daunting task. All worms were removed using snares and forceps.”

“While it is common to find worms in intestines, uncommonly, they are found in the bile duct. India has the highest number of cases related to worms as the deworming medication is not routinely administered,” said Dr. Khurana.

He added, “Usually roundworms are found in the intestines. Occasionally they can migrate to the bile duct causing pain, fever, and jaundice. There have been cases where we have seen two or three roundworms in the bile duct. However, to see fourteen worms is extremely rare. The patient had taken a second opinion at other hospitals which had misdiagnosed the condition and prescribed antibiotics for the pain. Once properly diagnosed, we managed to remove all the roundworms endoscopically in a single session. Immediately after the removal, the patient was pain-free.”

 “I was suffering from abdominal pain for the last 6 months. Every time I visited a doctor, I was prescribed antibiotics to subside my pain but nothing helped. With time I could not digest any food and vomited at least three to four times in a week. I continuously suffered from jaundice as well.  A month back my pain started to worsen and I could hardly eat anything. When I came to Fortis it had been a week since I had eaten anything. My pain was so bad that I could barely stand on my feet. I had lost over 12 kilos in a span of a month. Thankfully they were able to diagnose my condition. Once the surgery was completed I was completely pain-free. I am recovering and feeling much better now,” said the patient.

Roundworms infest in the human gut, where they feed and reproduce. The roundworm life cycle begins when the eggs from the adult worms living in the intestine are passed out with the feces. This leads to the contamination of the soil. These infections are mostly seen rural areas with poor sanitation and where contaminated soil is used as a fertilizer for fruits and vegetables.