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Wang XY, Hao Y, Wang ZJ, Xu XL, Yang JH. Clinicopathological differences between patients with schistosomal appendicitis and non schistosomal appendicitis: A retrospectively study of past ten years. World J Clin Cases 2025; 13:96557. [PMID: 39823100 PMCID: PMC11577507 DOI: 10.12998/wjcc.v13.i2.96557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 08/27/2024] [Accepted: 09/26/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases, especially the digestive system. Schistosome eggs are mainly deposited in the stomach, liver and colorectal, but a few eggs are deposited in the appendix and cause disease. At present, there are few studies on schistosomal appendicitis. AIM To explore the differences in epidemiological, clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis. METHODS The differences of general data, clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed. All patients were divided into two groups for analysis. There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group. RESULTS Schistosomal appendicitis accounted for 2.45% of all patients with appendicitis, and the annual proportion in the past decade was 2.2%, 2.9%, 1.8%, 1.9%, 3.4%, 3.1%, 1.9%, 1.6%, 3%, 2.6%, respectively. The prevalence of schistosomal appendicitis was middle-aged and elderly males, with an average age of 61.73 ± 15.335 years. The main population of non-schistosomal appendicitis was middle-aged men, with an average age of 35.8 ± 24.013 years (P < 0.001). The distribution of pathological types of appendicitis was different between the two groups (P < 0.001). The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis [odds ratio (OR) = 0.504; 95% confidence interval (CI): 0.349-0.728; P < 0.001]. The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis (OR = 2.614; 95%CI: 1.815-3.763; P < 0.001). The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of non-schistosomal appendicitis patients (OR = 5.087; 95%CI: 1.427-18.132; P = 0.012). There was no difference in clinical symptoms between the two groups. In the laboratory examination, there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis. The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range. Other statistically significant indicators were in the normal range. CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies, potentially leading to a poor prognosis. Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination. It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis, and to ensure early detection and treatment.
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Affiliation(s)
- Xiao-Yi Wang
- Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
| | - Yao Hao
- Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
| | - Zi-Jian Wang
- Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
| | - Xiu-Liang Xu
- Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
| | - Jiang-Hua Yang
- Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
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Zacarias M, Pizzol D, de Miranda H, Colangelo AC, Veronese N, Smith L. Schistosomal appendicitis: Case series and systematic literature review. PLoS Negl Trop Dis 2021; 15:e0009478. [PMID: 34166369 PMCID: PMC8224979 DOI: 10.1371/journal.pntd.0009478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. METHODS We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. FINDINGS A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). CONCLUSIONS Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.
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Affiliation(s)
- Mateus Zacarias
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | | | | | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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Imamura H, Haraguchi M, Isagawa Y, Morita M, Hirabaru M, Kawahara D, Tokai H, Noda K, Minami S, Inoue K, Irie J, Eguchi S. Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report. Surg Case Rep 2019; 5:55. [PMID: 30963331 PMCID: PMC6453986 DOI: 10.1186/s40792-019-0615-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Schistosomiasis is prevalent in tropical and subtropical areas and rarely reported in developed countries. Schistosomiasis often occurs as a chronic illness, which can cause liver and intestinal damage. Appendicitis is an unusual complication of schistosomiasis. We herein present a case of acute appendicitis associated with the presence of schistosome eggs in a sailor from the Philippines. Case presentation A 34-year-old Filipino man who worked as a sailor presented to our hospital with a 2-day history of acute right lower quadrant abdominal pain and fever. A physical examination revealed right lower quadrant abdominal pain with signs of peritoneal irritation, including rebound tenderness. Computed tomography revealed thickening of the appendix associated with mural calcification and fluid collection around the cecum. Based on these findings, the preoperative diagnosis was acute appendicitis. Laparoscopic appendectomy was performed. Swelling of the appendix and contaminated ascites were observed intraoperatively, but there was no evidence of appendiceal perforation. A histopathological examination showed inflammation of the appendix wall and numerous ovoid bodies present within the submucosa, many of which were calcified. Severe infiltration of lymphocytes and fibrosis were recognized around the oval bodies. The numerous oval bodies were morphologically consistent with schistosomiasis. The final diagnosis was acute phlegmonous appendicitis associated with the presence of schistosome eggs. We examined the patient for signs of adult worm activity, but the results of stool ova and parasite examinations performed twice were negative. He was discharged and returned to his country on postoperative day 9. Conclusions The incidence of schistosomal appendicitis, which is seldom reported in developed countries, is expected to increase in Japan in the near future. Clinicians should suspect schistosome eggs as a cause of acute appendicitis in patients who have emigrated from or are traveling from endemic areas, and when mural calcification of the appendix is observed on imaging.
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Affiliation(s)
- Hajime Imamura
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Masashi Haraguchi
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Yuriko Isagawa
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Masataka Hirabaru
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Daisuke Kawahara
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Hirotaka Tokai
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Kazumasa Noda
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Shigeki Minami
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Keiji Inoue
- Department of Surgery, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Junji Irie
- Department of Pathology, Nagasaki Harbor Medical Center, 6-39, Shinchi, Nagasaki city, Nagasaki, 850-8555, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan.
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Salih MA. A case of acute appendicitis due to intestinal schistosomiasis. Ann Med Surg (Lond) 2019; 37:1-3. [PMID: 30555690 PMCID: PMC6275170 DOI: 10.1016/j.amsu.2018.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/17/2018] [Accepted: 11/19/2018] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Intestinal Schistosomiasis is a parasitic disease caused by Schistosoma mansoni or Schistosoma japonica. Sudan is considered one of the endemic areas of schistosomiasis and many studies were done as regard to the prevalence and impact of the disease. Schistosomal appendicitis is rare, particularly in developed countries compared to endemic areas. CASE REPORT This is a case of 36 -year- old man with past history of schistosomiasis presented with features of intestinal obstruction to Ibrahim Malik teaching hospital in Khartoum-Sudan. Exploratory laparotomy revealed gangrenous appendix. Histopathology results came back as extensive necrosis of the appendix with multiple viable Schistosomal ova. Stool analysis revealed no ova. The patient received praziquantel therapy and now he is in a good condition. CONCLUSION Clinicians and pathologist should be aware of schistosomal appendicitis, particularly in endemic areas like Sudan.
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Affiliation(s)
- Callisto Madavo
- Department of Surgery, Newham General Hospital, London E13 8SL, UK.
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Zakaria OM, Zakaria HM, Daoud MY, Al Wadaani H, Al Buali W, Al-Mohammed H, Al Mulhim AS, Zaki W. Parasitic infestation in pediatric and adolescent appendicitis: a local experience. Oman Med J 2013; 28:92-6. [PMID: 23599875 DOI: 10.5001/omj.2013.25] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 12/17/2012] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The relationship between parasites and pediatric appendicitis is a highly debatable issue. This study aims to investigate the role of parasitic infestation in the etiology of acute pediatric appendicitis. METHODS A retrospective study including 1600 pediatric and adolescent patients who had undergone surgical therapy for a diagnosis of acute appendicitis over a period of ten years from Jan 2001 to Dec 2010. Demographic data were retrieved including the patient's age, sex, clinical data, clinical presentations, laboratory investigations, operative data and pathological findings to identify the presence and type of parasites. Patients were divided into two groups according to the presence or absence of parasites in the appendix lumen. In group I (n: 88), parasitic infestation was observed, whereas in group II (n: 1502), no parasitic infestation was present. RESULTS Parasites were present in 5.5% (88 patients), and of those 88 parasitic infestations, 45 (51.1%) were Enterobaisis, 8 (9.1%) were Schistosomiasis, 23 (26.1%) were Ascariasis, 7 (8%) Trichuriasis, and 5 (5.7%) were Teania Saginata. The percentage of patients with suppurative, gangrenous or perforated appendicitis was similar in both groups with no statistical significance, irrespective of the presence or absence of parasitic infestation. CONCLUSION The low prevalence of parasites among the appendectomy specimens did not support the notion that parasites were a major cause of appendicitis in pediatric patients.
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Affiliation(s)
- Ossama M Zakaria
- Division of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Kingdom Saudi Arabia
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Abstract
The pathologic spectrum of the inflamed appendix encompasses a wide range of infectious entities, some with specific histologic findings, and others with nonspecific findings that may require an extensive diagnostic evaluation. The appendix is exclusively involved in some of these disorders, and in others may be involved through extension from other areas of the gastrointestinal tract. This review discusses the pathologic features of bacterial, viral, fungal, and parasitic infections affecting the appendix, including adenovirus; cytomegalovirus; Yersinia, Actinomyces, Mycobacterium, or Histoplasma species; Enterobius vermicularis; schistosomiasis; and Strongyloides stercoralis. Pertinent ancillary diagnostic techniques and the clinical context and significance of the various infections are also discussed.
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Affiliation(s)
- Laura W Lamps
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
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Affiliation(s)
- Sadia Jama
- HealthPartners, Center for International Health, St Paul, MN, USA
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9
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Abstract
Schistosomal appendicitis is very rare in developed countries like the USA, Europe, and Japan. The author reviewed 311 pathologic archival specimens of vermiform appendix over the past 10 years. One case of schistosomal appendicitis was recognized. Therefore, the incidence of this disease was 0.32% in all appendices surgically resected in our hospital. The patient was a 41-year-old woman presenting with lower abdominal pain. She was a sailor traveling to many countries including endemic areas. Physical examination, laboratory data, and imaging modalities suggested an acute appendicitis, and appendectomy was performed under the diagnosis of ordinary appendicitis. Histologically, numerous schistosomal eggs were present in the vasculatures throughout the appendiceal walls. Some of the eggs were calcified. Stromal foreign body reaction was also recognized. The appendicitis was phlegmonous consisting of severe infiltrations of neutrophils and eosinophils. Acute serositis was also noted. Examination of feces revealed numerous eggs of Schistosoma mansoni. Clinicians should be aware of schistosomal appendicitis.
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10
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Intestinal schistosomiasis manifesting as colonic intussusception arising from a mucocele of the appendix: report of a case. Surg Today 2008; 38:664-7. [PMID: 18612796 DOI: 10.1007/s00595-007-3682-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 08/15/2007] [Indexed: 10/21/2022]
Abstract
We report a case of intestinal schistosomiasis manifesting as colonic intussusception resulting from a mucocele of the appendix, caused by the obstruction of appendiceal outflow by schistosome egg-induced fibrosis. An 81-year-old woman from China presented with a tender right iliac fossa mass and computed tomography (CT) showed intussusception in the ascending colon. Exploratory laparotomy confirmed an appendiceal mass causing intussusception of the cecum into the ascending colon, with the appendix as the lead point, and lymphnode enlargement. We performed a right hemicolectomy for the appendiceal tumor. However, histologic examination revealed schistosoma eggs within the mucosa, submucosa, muscularis propria, and subserosal fat of the appendix, cecum, and ascending colon, and lymph nodes. The absence of dysplasia in the appendiceal mucosa indicated that the mucocele had developed from fibrosis induced by schistosome eggs obstructing the luminal outflow of mucin. Postoperatively, the patient was given praziquantel and recovered well.
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11
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Andreu-Ballester J, Pérez-Griera J, Ballester F, Colomer-Rubio E, Ortiz-Tarín I, Pelayo V, Rodero M, Cuéllar C. Anisakis simplex and Kudoa sp.: Evaluation of specific antibodies in appendectomized patients. Exp Parasitol 2008; 119:433-6. [DOI: 10.1016/j.exppara.2008.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Revised: 03/25/2008] [Accepted: 03/26/2008] [Indexed: 11/25/2022]
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Nandipati K, Parithivel V, Niazi M. Schistosomiasis: A Rare Cause of Acute Appendicitis in the African American Population in the United States. Am Surg 2008. [DOI: 10.1177/000313480807400308] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Schistosomal appendicitis is rarely reported in developed countries. In this article we report a case series of schistosomal appendicitis at our community teaching hospital. In this retrospective study, we conducted a thorough database search for schistosomiasis in patients who had undergone appendectomy for acute appendicitis from 1995 to 2005. Of 1690 total appendectomies performed during this period, three cases of schistosomal appendicitis were identified. Data obtained included patient demographics, laboratory investigations, and pathological specimen. All patients belong to the African American race, are between the ages of 20 and 40 (mean 29.3 ± 9.5) years, and had onset of symptoms <24 hours in duration. Sudden onset of right lower abdominal pain with leucocytosis (14.1 ± 1.4 x 103) is a common feature. All patients underwent appendectomy and each was found to have an enlarged and inflamed appendix intraoperatively. Histopathology revealed transmural inflammation predominantly with neutrophils and scanty eosinophils. Schistosomal granulations are present in all layers of appendix including serosa. All patients had an uneventful postoperative recovery. Schistosomal appendicitis is an uncommon condition especially in developed countries like the United States. However, with recent changes in global migration, schistosomiasis should be considered as one of the causes for appendicitis, especially in the African American population.
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Affiliation(s)
- Kalyana Nandipati
- Departments of Surgery and
- Pathology, Bronx Lebanon Hospital, Albert Einstein School of Medicine, Bronx, New York and the
| | | | - Masooma Niazi
- Pathology, Bronx Lebanon Hospital, Albert Einstein School of Medicine, Bronx, New York and the
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13
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Lamps LW. Beyond acute inflammation: a review of appendicitis and infections of the appendix. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.mpdhp.2007.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Affiliation(s)
- Callisto Madavo
- Department of Surgery, Newham General Hospital, London E13 8SL, UK.
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15
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Rivasi F, Pampiglione S. Appendicitis associated with presence of Schistosoma haematobium eggs: an unusual pathology for Europe. Report of three cases. APMIS 2006; 114:72-6. [PMID: 16499665 DOI: 10.1111/j.1600-0463.2006.apm_314.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Three cases of appendicitis associated with presence of Schistosoma haematobium eggs in the appendix tissue are reported. The patients (two males and one female) were all from Ghana and had immigrated to Italy a few years previously. It is difficult to attribute the cause of the appendicitis to the parasite; it is more probable that the appendicular location of the eggs occurred accidentally many years earlier in an endemic zone of the country of origin, and that recently bacterial agents were able to provoke the present appendicitis. Since it is probable that with the increase in the number of immigrants to Europe from endemic countries (sub-Saharan Africa in particular) other similar cases may occur, it is important that the surgeon and the pathologist be aware of this pathology, which has so far been considered unusual.
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Affiliation(s)
- Francesco Rivasi
- Department of Pathological Anatomy and Forensic Medicine, Section of Pathological Anatomy, University of Modena and Reggio Emilia, Italy.
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16
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Abstract
The pathologic spectrum of the acutely inflamed appendix encompasses a wide range of infectious and noninfectious entities. The appendix suffers alone in some of these disorders, and in others may be involved through extension from other areas of the gastrointestinal tract. Although the appendix is the most commonly resected and examined intraabdominal organ, the pathogenesis and etiology of acute nonspecific appendicitis (the most common diagnosis made in this organ) remains enigmatic. This review encompasses the pathology, pathogenesis, and bacteriology of acute appendicitis, as well as controversial issues such as the diagnosis of chronic appendicitis and the significance of a morphologically unremarkable appendectomy specimen in the clinical context of appendicitis. In addition, the pathologic features, pertinent diagnostic techniques, and clinical significance of several specific bacterial, viral, fungal, and parasitic infections affecting the appendix are presented, including adenovirus, cytomegalovirus, Yersinia species, actinomycosis, Mycobacteria species, histoplasmosis, pinworms, schistosomiasis, and Strongyloides stercoralis.
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Affiliation(s)
- Laura W Lamps
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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17
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Mathebula SD, Lahri S. Letter to the Editor. S Afr Fam Pract (2004) 2005. [DOI: 10.1080/20786204.2005.10873207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
Granulomatous inflammation of the appendix is uncommon. It can be caused by a variety of conditions, including systemic disorders such as Crohn's disease and sarcoidosis, and infections such as mycobacterium tuberculosis, yersinia pseudotuberculosis, parasites and fungi. Granulomatous appendicitis as an isolated pathological entity unassociated with systemic disease is rare. Isolated granulomatous inflammation of the appendix of unknown aetiology, otherwise known as idiopathic granulomatous appendicitis is extremely rare. Patients with this condition present with the typical signs and symptoms of acute appendicitis. We present a series of patients with isolated granulomatous inflammation of the appendix, and discuss the difficulties encountered in the management of this condition.
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Affiliation(s)
- O N Tucker
- Department of Surgery, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
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Doudier B, Parola P, Dales JP, Linzberger N, Brouqui P, Delmont J. Schistosomiasis as an unusual cause of appendicitis. Clin Microbiol Infect 2004; 10:89-91. [PMID: 14759233 DOI: 10.1111/j.1469-0691.2004.00805.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.
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Affiliation(s)
- B Doudier
- Service des Maladies Infectieuses et Tropicales, Center Hospitalo-Universitaire Nord, Marseille, France
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21
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Abstract
Schistosomiasis, a waterborne trematode infestation, is one of the most widespread parasitic diseases in the world. It occurs in well-defined endemic geographical areas. Schistosomiasis of the appendix was first described by Turner in 1909, and has been reported from endemic areas. However, appendicular schistosomiasis in travelers has not been reported in the English literature. We describe an Israeli traveler with acute appendicitis as the presenting symptom of schistosomiasis, 2 years after a visit to Africa.
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Affiliation(s)
- G Weber
- Infectious Diseases Institute, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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22
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Donaldson BA, Gopalan V, Freeman H, Levowitz B. Schistosomiasis: an unusual cause of right lower quadrant abdominal pain. J Natl Med Assoc 1997; 89:461-3. [PMID: 9220695 PMCID: PMC2568091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Schistosomiasis, although unusual in North America, is a common disease worldwide. Symptoms vary depending on the species involved. Immigrants from endemic regions are the commonly affected patients found in North America. In most cases, schistosomiasis does not present with right lower quadrant pain. Even in endemic regions, this form of presentation is uncommon. In the United States, most cases of right lower quadrant pain often will be treated as appendicitis. Questions remain unanswered as to whether the schistosomes cause appendicitis or are found incidentally in these cases. Stool and urine specimens may be helpful in making a diagnosis. Most cases require operative intervention to rule out appendicitis and to obtain tissue for histopathologic diagnosis. Praziquantel is effective in eradicating infestations.
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23
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McCue J, Coppen MJ, Rasbridge SA, Lock MR. Crohn's disease of the appendix. Ann R Coll Surg Engl 1988; 70:300-3. [PMID: 3056207 PMCID: PMC2498833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
This study reports eight patients who underwent appendicectomy between 1978 and 1986 for apparently isolated, previously undiagnosed Crohn's disease of the appendix. All patients have since remained well with no sign of disease recurrence. This may represent a less aggressive form of Crohn's disease or be a different entity, namely granulomatous appendicitis.
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Affiliation(s)
- J McCue
- Department of Surgery, Whittington Hospital, London
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