Taenia infestation of bowel is generally known not to produce any symptoms other than vague abdominal discomfort. We report here, a patient, who 'had intestinal perforation with Taenia saginata.

A four-year-old female child presented with distension of abdomen and constipation for 2 days. On examination she had slight tachycardia, dehydration and pallor. The abdomen was mildly distended with sluggish bowel sounds. An erect X-ray of abdomen was inconclusive. She was started on intravenous fluids and nasogastric suction. However, she did not respond and the aspirate from the nasogastric tube increased and became bilious alongwith progressive distension and absent bowel sounds. An X-ray abdomen taken two days later revealed air fluids levels suggestive of small bowel obstruction and an exploratory laparotomy was performed. There was a 15 cm long segment of bowel approximately 75 cm proximal to the ileocecal junction which was gangrenous. The bowel was sealed with omentum at the site of perforation and a loop twisted over the adherent omentum resulting in gangrene. Underlying the perforation was a tape-worm measuring 1 meter long. The gangrenous segment was resected and an end to end double layered anastomosis was performed after removing the worm. The patient recovered well. A stool examination revealed ova of Taenia saginata. She was de- wormed using Albendazole 400 mg daily for 3 days.

Many forms of worm infestation produce or mimic anatomic disease of the gatrointestinal tract. Our patient was found to be infested with Taenia saginata. This cestode has a world wide distribution. In India, it is particularly common among Mohammedans but it is generally not found amongst Hindus, who do not as a rule eat beef(1). The adult worm lives in the small intestine of man. It is white and semi-transparent, measuring 5-10 meters in length, but may be upto 24 meteres. Taenia saginata is also known as the Beef Tapeworm. The adult worm probably causes no symptoms in a majority of patients. Vague abdominal discomfort, hunger pains and chronic indigestion have been reported.

There are various reports of different types of surgical presentation with Ascariasis, Echinococcus granulosus, Enterobious, etc. However, few report of complications with Taenia. Only one or two reports of intestinal obstruction and appendicits have been ascribed to tapeworm infestation(2). In rare cases, scolex of T.solium may perforate the intestinal wall and initiate peritonitis.

P .K. Jain,
K.S. Budhwani,
Anju Gambhir,
Department of Pediatric Surgery,
Gandhi Medical College
and Hamidia Hospital, Bhopal,
India.