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Intestinal parasites

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Parasitic infection - intestinal

The two main types of intestinal parasites are helminths and protozoa. Helminths are worms with many cells. Tapeworms, pinworms, and roundworms are among the most common helminths in the United States. In their adult form, helminths cannot multiply in the human body. Protozoa have only one cell, and can multiply inside the human body, which...

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The Basics

Tests for Parasitic infection - intestinal

Stool ova and parasites exam

A Closer Look

Amebic liver abscess

Amebic liver abscess is a collection of pus in the liver in response to an intestinal parasite called Entamoeba histolytica. This parasite causes amebiasis, an intestinal infection that is also called amebic dysentery. After an infection has occurred, the parasite may be carried by the bloodstream from the intestines to the liver.

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Amebic brain abscess

Amebiasis, normally an infection of the intestinal tract, may spread and infect other organs such as the liver or brain. Infection of the brain can be fatal. In this slide, ameba are shown in a sample of brain tissue. Ameba represent a serious infection in immunocompromised individuals. (Image courtesy of the Centers for Disease Control and Prevention. )

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Giardiasis

Giardiasis is an intestinal infection caused by a protozoan and is spread by contaminated water or contact with an infected person. People who are travelling or hiking should assume water sources are contaminated and either purify drinking water or drink bottled water. Healthcare or daycare workers should practice good hygiene when going from person to person. Unprotected anal sex can also transmit Giardiasis from an infected person to the partner.

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Small intestine tissue sample

A sample of small intestine is obtained by the use of a flexible scope that is passed through the digestive tract to the small intestine. In the small intestine, a small sample is removed and placed on a microscope slide. The sample is stained and sectioned (sliced) for histological (tissue) examination. The test is performed to diagnose an infection or parasitic infestation of the small bowel.

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Ascaris lumbricoides egg

This is an egg of Ascaris lumbricoides. Ascarides are roundworms, a common parasitic infection throughout the world. It is estimated that as many as 1 billion people (one sixth of the world population) may be infected with roundworms.

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The wet mount vaginitis test

A vaginitis test looks for the cause of vaginal irritation and discharge, which is usually a yeast, bacterial, or parasitic infection.

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Duodenum tissue smear

A duodenal tissue smear is performed by inserting an endoscope through the mouth down into the duodenum. When the tube is in place, it suctions out some of the fluid located in the duodenum. When the procedure is over the tube is removed. The sample is sent to the laboratory for testing. The test is performed to diagnose infection or parasitic infestation of the small bowel.

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Intestinal gas

Gas is formed in the intestines by the action of bacteria as food is being digested. Gas is also called flatus or flatulence, and is passed through the intestine and out the body through the rectum.

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Large bowel resection - series

Presentation

<strong>Indications</strong><p>Bowel resection may be indicated for blockage of the intestine (intestinal obstruction) due to scar tissue or tumors, bleeding, due to diverticulosis or arteriovenous malformations, injuries, cancer, precancerous polyps, familial polyposis, and infection, due to diverticulitis.</p>

<strong>Incision</strong><p>The patient is deep asleep and pain-free (general anesthesia). A lower midline incision is made in the abdomen. Sometimes, the surgeon will use a lateral lower transverse incision instead.</p>

<strong>Procedure, part 1</strong><p>The diseased part of the large intestine (colon) is removed. The two healthy ends are then sewn or stapled back together and the incision is closed. A stapling procedure is shown here.</p>

<strong>Procedure, part 2</strong><p>If it is necessary to spare the intestine from its normal digestive work while it heals, a temporary opening of the intestine onto the abdomen (colostomy) may be done. A temporary colostomy will be closed and repaired later. If a large portion of the bowel is removed, the colostomy may be permanent. The large intestine (colon) absorbs most of the fluid from foods. When the colon is bypassed by a colostomy in the right colon, the colostomy output is generally liquid stool (feces). If the colon is bypassed in the left colon, the colostomy output is generally more solid stool. The constant or frequent drainage of liquid stool can cause the skin around the colostomy to become inflamed. Careful skin care and a well-fitting colostomy bag can reduce this irritation.</p>

<strong>Aftercare</strong><p>Most patients will stay in the hospital for 5 to 7 days. Complete recovery from surgery may take 2 months. During the first few days after surgery, eating is restricted.</p>

Small bowel resection - series

Presentation

<strong>Indications</strong><p>Resection of the small bowel may be recommended for Blockage of the intestine (intestinal obstruction) due to scar tissue or deformities; Bleeding, infection, or ulcers due to inflammation of the small intestine (regional ileitis, regional enteritis, Crohn's disease); Injuries; Cancer; Precancerous polyps.
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<strong>Incision</strong><p>The patient is deep asleep and pain-free (general anesthesia). An incision is made into the abdomen.</p>

<strong>Procedure</strong><p>The diseased part of the small intestine (ileum) is removed. The two healthy ends are then sewn back together and the incision is closed. If it is necessary to spare the intestine from its normal digestive work while it heals, a temporary opening (stoma) of the intestine onto the abdomen (ileostomy) may be done. A temporary ileostomy will be closed and repaired later. If a large portion of the bowel is removed, the ileostomy may be permanent. The ileum absorbs much of the fluid from foods. When the large intestine is bypassed by an ileostomy, the patient should expect liquid stool (feces). The constant or frequent drainage of liquid stool can cause the skin around the ileostomy to become inflamed. Careful skin care and a well-fitting ileostomy bag can reduce this irritation.</p>

<strong>Aftercare</strong><p>The outcome depends on the disease. Most patients will stay in the hospital for 5 to 7 days. Complete recovery from surgery may take 2 months. During the first few days after surgery, eating is restricted.</p>

Appendectomy - series

Presentation

<strong>Indications</strong><p>If the appendix becomes infected it must be surgically removed before it ruptures and spreads infection to the entire abdominal space. Symptoms of acute appendicitis include pain in the lower right side of the abdomen, fever, reduced appetite, nausea or vomiting. Before surgery, the doctor will perform a physical exam. The physician will check the abdomen for tenderness and tightness and check the rectum for tenderness and an enlarged appendix. In women, a pelvic exam is also performed to exclude pain caused by the ovaries or uterus. Additionally, blood tests and x-rays may also be performed. There is no test to confirm appendicitis and the symptoms may be caused by other illnesses. The doctor must diagnose from the information you report and what he sees. During appendectomy surgery, even if the surgeon finds that the appendix is not infected (which can happen up to 25% of the time), he will thoroughly check the other abdominal organs and remove the appendix anyway.</p>

<strong>Incision</strong><p>Depending upon the circumstances of the individual patient, an appendectomy can be performed in one of two ways, through an open incision or with a laparoscope. In the open technique, an incision is made in the lower right side of the abdomen, through the skin, muscle wall, and peritoneum. The appendix is located and then carefully freed from the surrounding structures and removed. In the laparoscopic technique, several small incisions are made in the abdomen. In one incision a laparoscope is inserted. The laparoscope has a tiny lens to which a TV camera is attached. The appendectomy is performed by the surgeon while looking at the TV monitor. Small instruments are inserted in the other incisions and used to remove the appendix.</p>

<strong>Procedure</strong><p>If a pocket of infection has formed, or the appendix has ruptured, the abdomen will be thoroughly washed out during surgery. The surgeon may then leave the skin open and allow it to heal together on its own, to allow the infection to drain, or less frequently, put in a small drainage tube.</p>

<strong>Aftercare</strong><p>Recovery from a simple appendectomy is usually complete and rapid. Most patients can go home the day after the operation, and resume normal diet and activities within one to two weeks. If the appendix has developed an abscess or has ruptured, the recovery may be slower and more complicated, requiring use of medications to treat the infection (antibiotics). Living without an appendix causes no known health problems.</p>

Abdominal exploration - series

Presentation

<strong>Indication</strong><p>The surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal disease from an unknown cause (to diagnose), or trauma to the abdomen (gunshot or stab-wounds, or blunt trauma). Diseases that may be discovered by exploratory laparotomy include inflammation of the appendix (acute appendicitis), inflammation of the pancreas (acute or chronic pancreatitis), pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess), presence of uterine tissue (endometrium) in the abdomen (endometriosis), inflammation of the Fallopian tubes (salpingitis), scar tissue in the abdomen (adhesions), cancer (of the ovary, colon, pancreas, liver), inflammation of an intestinal pocket (diverticulitis), hole in the intestine (intestinal perforation), pregnancy in the abdomen instead of uterus (ectopic pregnancy), to determine the extent of certain cancers (Hodgkin's lymphoma).</p>

<strong>Procedure</strong><p>While the patient is deep asleep and pain-free (general anesthesia), the surgeon makes an incision into the abdomen and examines the abdominal organs. Different incisions are sometimes used depending on the circumstance. Common incisions include a vertical midline incision, and right or left upper or lower quadrant transverse incisions. Tissue samples (biopsies) can be taken and diseased areas can be evaluated. When the treatment is complete, the incision is closed with either sutures or skin staples.</p>

<strong>Aftercare</strong><p>The outcome from surgery varies with the disease process, as does the course and duration of recovery. Exploratory laparotomy is most commonly performed for trauma, severe abdominal pain of unknown cause, intestinal obstruction, inflammatory diseases like appendicitis and diverticulitis, and cancer of any of the abdominal organs.</p>

Appendectomy - series

Presentation

Large bowel resection - series

Presentation

Intestinal obstruction repair - series

Presentation

<strong>Indication, part 1</strong><p>Obstruction of the intestine occurs when food and water cannot pass through the intestine. The area of intestine nearest to the obstruction becomes dilated and non-functioning. If the obstruction is not relieved, it can lead to intestinal gangrene and perforation.</p>

<strong>Indication, part 2</strong><p>The most common causes of intestinal obstruction in adults are adhesions, hernias, and colon cancer. Adhesions are scars that form between loops of intestine, usually caused by prior surgery, which causes such scar formation. Hernias are areas of weakness in the abdominal wall, through which loops of intestine can slip and become trapped. Colon cancer is one of the most common forms of cancer. While each reason for intestinal obstruction requires a different treatment, all intestinal obstructions are potentially life-threatening.</p>

<strong>Incision</strong><p>In most cases, surgery is necessary. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the midline of the abdomen. In the case of adhesions, the adhesion is removed, thus relieving the obstruction. In the case of a hernia, the hernia is repaired. If colon cancer is present, cancerous areas are removed, which also relieves the obstruction.</p>

<strong>Procedure</strong><p>In all cases, the intestine involved in the obstruction is examined. If any parts of the intestine look unhealthy from lack of blood flow during the period of obstruction, they are removed and the healthy ends are reconnected. A patient's recovery depends on several factors, including the cause of the intestinal obstruction and the length of time prior to relief of the obstruction.</p>

Review Date: 4/27/2016+

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