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Although 99% of ascarids are found in the jejunum and ileum, they may be anywhere in the alimentary tract from the esophagus to the rectum. The adult worms are freely mobile within the lumen of the gut and rarely cause any specific pathological findings. However, if they are present in large numbers, as occurs especially in children, they may cluster into a large bolus, producing partial or complete intestinal obstruction (Fig. 10.5).


Fig. 10.5A-C. Tangled masses of ascarids. (A and B) A large bolus of ascarids blocking the intestinal lumen. (C) Autopsy specimen of a colon infected with Ascaris lumbricoides, Trichuris trichiura, Balantidium coli and Entamoeba histolytica. Adult worms of Ascaris and Trichuris are present as well as ulcerations and bloody intestinal contents caused by simultaneous balantidiasis and amebiasis.


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