How do you feel when you see noodles like thing (worms) coming through nose and abdominal wound???
We treated one such patient successfully during my Surgery training in Pune. This young lady was presented to our casualty with c/o pain in abdomen for two days associated with low grade fever. Her blood pressure and pulse were normal but she was having severe pain on pressing of her abdomen. On investigating her with USG and X ray of abdomen we diagnosed her with intestinal obstruction.
We operated her but due to dense adhesion between bowel loops, we could not do much during the surgery. We suspected that she was having tubercular peritonitis and started her on antitubercular therapy. She was doing well for initial 3-4 days. But later we noticed greenish coloured fluid coming out through the separated abdominal wound edges (Wound gaping).
Next day morning we really got surprised by seeing worms coming through the tube inserted through nose and abdominal wound. We had not seen such a case before. Those were Ascaris. Ascaris lumbricoides is the "large roundworm" of humans and grows to a length of up to 35 cm (14 in). We did her wound dressing on a daily basis for almost 2-3 weeks. Meanwhile we started her on deworming treatment and protein supplements. She responded well to the treatment and was discharged after 1 and half months of hospitalization.
She came to OPD after three months with a smile on her face. I still remember, our professor was so happy and praised all residents for the efforts and dedication we took to make her live healthy life again.
Image source (Representative image only) : ascarislumbricoides.org