Ultrasound Reveals Roundworms in Man’s Stomach

Doctors find roundworm in man's stomach
Source: Chaurasia & Bhoi, NEJM, 2020
  • A 20-year-old man presented to the emergency department with common gastrointestinal symptoms
  • Ultrasound revealed a tubular structure moving inside the patient’s stomach
  • A stool sample confirmed the presence of roundworm Ascaris lumbricoides, a common parasitic worm

According to a case report published in The New England Journal of Medicine, doctors in India discovered the roundworm Ascaris Lumbricoides squirming around inside a patient’s stomach. 

The 20-year-old man had presented to a hospital in New Delhi, India, with complaints of acute abdominal pain, diarrhea, and vomiting. All of which are common gastrointestinal symptoms. Upon examination, the patient was hypotensive with a blood pressure of 96/60 mmHg. Furthermore, laboratory results showed an elevated white blood cell count and hemoglobin concentration. 

While white blood cells usually indicate infection, an increase in hemoglobin often points to heart disease, dehydration, or blood cancer. Suspecting one of the three, doctors planned an ultrasound of the inferior vena cava to assess the amount of fluid within his blood vessels.

The ultrasound, however, revealed something completely unexpected.

A Tangle of Worms

During the ultrasound, doctors noticed strange ‘tubular’ structures moving in a ‘curling motion’ within the patient’s stomach. Keeping in mind the patient’s location, complaints, and ultrasound findings, doctors realized it could be nothing but a roundworm infection.

Roundworm Ascaris Lumbricoides. found swimming in man's stomach
Source: (Chaurasia & Bhoi, NEJM, 2020)

Therefore, researchers collected a stool sample and examined it for the eggs of Ascaris lumbricoides. Once confirmed, doctors then administered a single dose of albendazole, a common antiparasitic drug. A day later, the patient was discharged from the hospital. 

1.2 Billion People Infected with Ascaris Lumbricoides 

Ascaris Lumbricoides is one of the most common human parasitic worms. An estimated 1.7 billion people suffer from worm infections worldwide. Ascaris infections account for 1.2 billion of these cases. In subtropical countries such as India, where the weather is warm and there are poor hygiene and sanitation facilities, such infections are even more common. 

Infection generally occurs from coming in contact with water or food contaminated with roundworm eggs. Ascaris Lumbricoides eggs are one of the hardest to kill as they are resistant to heat and chemicals. Thus, they can survive in the soil for up to several years. Ingesting unwashed fruits and vegetables grown in contaminated soil can cause infection. Soil contamination is common in places with poor sanitation. As well as, in places that use human feces as fertilizers.

It Begins and Ends in the Stomach

After ingestion of the egg, the larva hatches and penetrates the walls of the digestive tract. It then migrates through the bloodstream to the heart, liver, and lungs. Within the lungs, the larva matures into an adult worm. The worm is either coughed out or, swallowed back into the intestines. Inside the digestive tract, the worms produce eggs which are passed out through the individual’s stool. 

These worms can grow up to a length of 14 inches long and can therefore result in intestinal obstruction in rare cases. Common symptoms of ascariasis include cough, abdominal pain, fever and intestinal ulcers.   

According to the case report, a follow-up was conducted at two weeks. The patient reported passing worms in his stool and being in good health. 


Chaurasia, V., & Bhoi, S. (2020). Ascaris in the Stomach. New England Journal of Medicine, e122. doi:10.1056/nejmicm2007312 

Parija SC, Chidambaram M, Mandal J. Epidemiology and clinical features of soil-transmitted helminths. Trop Parasitol 2017;7:81-5


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