Intestinal ascariasis and appendicitis

There are long tubular structures seen Intraluminal or within the small bowel loops, with sharply echogenic wall and hypoechoic centrally, its diameter measuring 4 mm, seen in epigastric and left upper quadrant regions likely worms.

There is a long tubular, non-compressible, aperistaltic, blind-ending bowel loop with a hypoechoic wall in the right iliac fossa, curved on itself containing fluid with some internal echoes, AP diameter 6 mm to 9 mm, wall thickness 3 mm, typical of acute appendicitis. The mesentery around it is quite hyperechoic, edematous, inflamed thickened and there is significant peri appendicular hypervascularity in the adjacent mesentery.  There is a localized fluid collection of about 1.5 to 2 cc.