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Ascariasis presenting as hematemesis in a young boy

Most cases of round worm infestation are asymptomatic. Their migration to various unusual sites in the gastrointestinal tract leads to uncommon complications such as acute pancreatitis, biliary cholangitis, acalculus cholecystitis, and so on. Accumulation of worms inside intestinal lumen can lead to obstruction, intussuception, or volvulus. However, migration of the worm in the stomach and consequent hematemesis is a very rare complication. Acidic milieu of stomach and its strong peristalsis are considered to be the reason for this rarity. Mechanism of hematemesis is assumed to be erosion of the mucosa either by mechanical process or by the secretions of the worm. This young boy being presented here had vague abdominal complaints and later developed hematemesis along with vomiting out of three living round worms. He brought the worm to hospital and contributed in making prompt diagnosis. He was treated conservatively.