Jordan Mary M, Sanders Jennifer E, Stallworth Christina R, Russell Scott, Titus Olivia, Hill Jeanne G, Cina Robert A
Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Am Surg. 2013 Sep;79(9):873-4.
Enterobius vermicularis is a parasite that inhabits the human digestive tract. We present two pediatric patients with symptoms mimicking acute appendicitis who were found to have E. vermicularis infection. The first case is a 5-year-old female who presented with flank and abdominal pain associated with low-grade fever and anorexia. She had localized tenderness in the right lower quadrant and a leukocytosis with left shift. Intraoperative findings included a normal-appearing appendix, but ex vivo examination revealed Enterobius vermicularis. The second case is a 7-year-old female who presented with periumbilical abdominal pain, anorexia, and emesis. She had tenderness at McBurney's point, and ultrasound revealed a small echogenic focus within the appendix. Intraoperatively, the distal tip of the appendix appeared inflamed. Again, ex vivo examination revealed E. vermicularis. Enterobius vermicularis infection of the appendix can present with a clinical picture similar to acute appendicitis. In at-risk populations, it should be included in the differential diagnosis for children with right lower quadrant abdominal pain. Complete therapy requires treatment with mebendazole.
蛲虫是一种寄生于人体消化道的寄生虫。我们报告了两名表现出类似急性阑尾炎症状的儿科患者,他们被发现感染了蛲虫。第一例是一名5岁女性,表现为胁腹和腹痛,伴有低热和厌食。她右下腹有局部压痛,白细胞增多并伴有核左移。术中发现阑尾外观正常,但离体检查发现了蛲虫。第二例是一名7岁女性,表现为脐周腹痛、厌食和呕吐。她在麦氏点有压痛,超声显示阑尾内有一个小的强回声灶。术中,阑尾远端看起来有炎症。同样,离体检查发现了蛲虫。阑尾的蛲虫感染可表现出与急性阑尾炎相似的临床表现。在高危人群中,对于右下腹痛的儿童,应将其纳入鉴别诊断。完整的治疗需要使用甲苯达唑进行治疗。