Komenaka Ian K, Wu George C H, Lazar Eric L, Cohen Jason A
Columbia-Presbyterian Hospital, New York, NY 10032, USA.
J Pediatr Surg. 2003 Sep;38(9):E8-10. doi: 10.1016/s0022-3468(03)00415-9.
Appendicitis is one of the most common causes of acute surgical disease in children and young adults. Parasites, however, are one of the uncommon etiologies. An 8-year-old girl and her 7-year-old sister presented with more than 2 months of chronic abdominal pain that became worse over a 1-week period before presentation. The 2 sisters presented 1 month apart. Both had similar symptomatology and physical examination findings. At operation, the surgical findings included an inflamed appendix with a cross section of the parasite Strongyloides. Strongyloides appendicitis has occurred almost exclusively in areas endemic to the parasite. Its environment is more common outside the United States but occasionally is seen in the Southeast region and in institutionalized individuals. The presentation of acute exacerbation of chronic abdominal pain coupled with the pathologic finding of Strongyloides in an acutely inflamed appendix, should alert the clinician of other possible cases. This increased index of suspicion will allow more prompt diagnosis and help avoid the morbidity of delayed operation.
阑尾炎是儿童和青年急性外科疾病最常见的病因之一。然而，寄生虫是不常见的病因之一。一名8岁女孩和她7岁的妹妹出现了超过2个月的慢性腹痛，在就诊前1周内病情加重。这两姐妹相隔1个月就诊。两人都有相似的症状和体格检查结果。手术中，手术所见包括发炎的阑尾，阑尾横切面上有类圆线虫寄生虫。类圆线虫性阑尾炎几乎只发生在该寄生虫的流行地区。其发病环境在美国以外地区更常见，但偶尔也可见于东南部地区和机构收容人员。慢性腹痛急性加重的表现，再加上急性发炎的阑尾中发现类圆线虫的病理结果，应提醒临床医生注意其他可能的病例。这种更高的怀疑指数将有助于更迅速地做出诊断，并有助于避免延迟手术带来的发病率。
