Friday, September 19, 2008

Obstruction 3

A 3 year old boy living in Asia presents with intermittent colicky abdominal pain, vomiting, and constipation. On exam, you feel an abdominal mass near the ileocecal valve area. In the past, he has had longstanding abdominal discomfort, anorexia, nausea, and diarrhea. About a month ago, he had an irritating nonproductive cough, pleuritic chest pain, rales, and wheezing. Laboratory tests at the time showed eosinophilia. Luckily, you recognize the cause:

Challenge: What is the disease?

Image is in the public domain.

2 comments:

Alex said...

loffler's syndrome

Craig said...

yep!
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Obstruction 3

This is caused by ascaris lumbricoides, an intestinal roundworm. When Ascaris larvae pass through the lungs, they can cause a transient eosinophilic pulmonary infiltrate, referred to as Loeffler’s syndrome. Ascaris can also cause intestinal infection and obstruction. Mainstays of therapy include albendazole and mebendazole. The image shows the egg which is passed through contaminated soil.

Sources: UpToDate; nlm.nih.gov.