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Ileal intussusception is the invagination of the small intestine within itself and accounts for 1% of cases of acute obstruction. However, physicians do not initially consider intussusception as a possible diagnosis of obstruction due to its rarity in adults. Herein, we report the case of a 22-year-old male who was admitted to the Emergency Department with continuous abdominal pain. Ultrasonography and computed tomography revealed an ileal intussusception. The patient underwent surgical removal of the segment of the small bowel. Unexpectedly, pathology revealed that the invagination occurred due to a parasite egg, with features suggestive of Schistosoma species. Schistosomiasis, although considered a parasitic disease in tropical countries, is not absent from Europe and though it is highly improbable, it may be responsible for cases of intussusception in adults.

Whilst colonic amoebiasis and its complications are well-documented, ileal amoebiasis has not been described in the literature. We report the cases of two patients with ileal amoebiasis and outline their management and outcome. It is important that surgeons working in areas endemic for amoebiasis be mindful of this entity.

Ascaridiosis is a usually benign disease caused by the parasite Ascaris lumbricoides. Medical treatment is usually sufficient. Prevalence in tropical zones is high, sometimes leading to severe surgical complications requiring treatment and having a high morbidity and mortality. Codified treatments are needed to reduce the incidence of ascaridiosis. Large scale prevention is needed, especially in endemic zones.

A case of intestinal anisakiasis is reported. The patient came with the symptoms of acute abdominal obstruction. The diagnosis was obtained by identification of the parasite in the tissue sections of the resected segment of the small intestine. This case appears to be the first reported case in Thailand.

Amongst 50 patients with surgical complications of Ascaris lumbricoides 35 patients (70%) were treated conservatively and 15 patients (30%) required surgical intervention which included squeezing of worms to distal colon, resection and anastomosis of ileum, appendicectomy and peritoneal lavage. Intestinal perforation was observed in 3 cases. Two patients (4%) died because of postoperative complications. Those presenting with subacute intestinal obstruction had no mortality or morbidity. Although a large number of roundworms were seen in the jejunum, the obstruction was generally observed in the distal ileum.

A 43-year-old man, with a chief complaint of abdominal pain and a palpable mass in the lower abdomen, was admitted to this hospital. He had 2-3 episodes of diarrhea monthly for several years. Laparotomy revealed the mass resembling sarcoma, invaded the ileum and bladder and also it had disseminated lesions in the other intraabdominal organs. Resected tissues showed actinomycotic abscess. AB-PC was administered post-operatively, with a satisfactory prognosis. On the 71 patients with abdominal actinomycosis who underwent laparotomy during the past 32 years in Japan, 42 were males and 28 females. Many of them were in their forties or fifties. Some literatures mention the ileocecal region as the usual site of following perforated appendicitis. As far as this review is concerned, however, the transverse colon was as frequently affected as the ileocecal region and it was only in 13 patients that acute appendicitis preceded the infection. Abdominal actinomycosis is not an uncommon disease and should be taken into consideration in the differential diagnosis of the abdominal mass.