Vleeschouwers W, Hofman Ph, Gillardin J P, Meert V, Van Slycke S
Department of General Surgery, OLV Aalst, Belgium.
Acta Chir Belg. 2013 Mar-Apr;113(2):139-42.
A 17-year-old female patient presented with the clinical features of an acute appendicitis. During laparoscopic exploration a macroscopically normal appendix was found. Since there were no intra-abdominal abnormalities found, the appendix was resected. Anatomopathology demonstrated Enterobius vermicularis, a pinworm infecting only humans, and mostly living in the caecum. This parasite is responsible for possibly the most common helminthic infection in the developed world. Its role in the pathogenesis of acute appendicitis is controversial, but more recent studies indicate a stronger association between enterobiasis and appendicitis. Often, enterobius mimics appendicitis by obstructing the lumen of the appendix, thereby causing appendiceal colic. This case report stresses the importance of microscopic examination of all appendectomy resection specimens. In case of enterobius infestation, systemic therapy of patient and family is necessary.
一名17岁女性患者表现出急性阑尾炎的临床特征。在腹腔镜探查过程中,发现阑尾在宏观上是正常的。由于未发现腹腔内有异常情况,遂将阑尾切除。解剖病理学检查显示有蛲虫,这是一种仅感染人类且大多寄生于盲肠的线虫。这种寄生虫可能是发达国家最常见的蠕虫感染源。其在急性阑尾炎发病机制中的作用存在争议,但最近的研究表明蛲虫病与阑尾炎之间的关联更为密切。通常,蛲虫会通过阻塞阑尾腔来模拟阑尾炎,从而引起阑尾绞痛。本病例报告强调了对所有阑尾切除标本进行显微镜检查的重要性。若发生蛲虫感染,对患者及其家人进行全身治疗是必要的。