Een man met peroperatief vrijkomende parasieten

An 18-year-old man came to the Emergency Room at the Academic Hospital Paramaribo (Suriname) with a solitary supra-umbilical gunshot-wound. The patient was hypovolemic, with dropping blood pressure and rising pulse, surgery was indicated. After incision of the abdominal midline 1.5 l of blood drained, immediately followed by the appearance of 2 long thin worms. During inspection of the abdominal cavity a perforation of the duodenum and sigmoid and a mesenterial bleeding was seen and treated. Inspection of the small intestine showed presence of Ascaris lumbricoides (roundworm).