Spitale Luis Santos, Pizzi Rogelio Daniel, Tomas Axel, Paez Rearte Mirtha Gladys, Pizzi Hugo Luis
Cátedra de Patología FCM. UNC.
Rev Fac Cien Med Univ Nac Cordoba. 2017 Sep 8;74(3):277-280. doi: 10.31053/1853.0605.v74.n3.16860.
Sixty-five cases of enterobiasis of the cecal appendix are reported by Enterobius vermicularis or Oxiurus vermicularis. Enterobiasis is a cosmopolitan parasite5,8,13 and frequent. It is useful to establish whether it can cause appendicitis and the mechanisms involved. According to the classical literature, E. vermicularis is not a causative agent of appendicitis per se, but allows the reproduction of the germs that infiltrate the wall and produce appendicitis5,9,10. The purpose of the study is to report the prevalence of E. Vermicularis in surgical appendicitis and the anatomopathology to deduce a causal relationship. We report a sample of 2000 surgical pieces of extracted appendages (1992-2003) at the Emergency Hospital of the city of Córdoba, Argentina. On a total of 2000 pieces, we observed 65 cases of appendicular enterobiasis; in 60 cases (3.25%) there was no histopathology of acute inflammation (anodyne cecal appendix). In the remaining 5 cases (0.25%) we observed coexistence of parasites in the appendicular lumen, acute transmural inflammatory infiltrates (acute appendicitis) and fecalitos, which would support the obstructive type etiopathogenesis that leads to the surgical picture. The appendicular location of Enterobius vermicularis would favor the formation of fecalitos in light and the proliferation of germs in the wall that would lead to appendicitis. Reports indicate that the parasitic infection constitutes a percentage of the etiologies in appendicitis and fecalitos are the most common trigger, some parasites (Enterobius vermicularis) may be involved in its formation, although this percentage is minimal9,10,15,16,17 .
本文报告了65例由蠕形住肠线虫（Enterobius vermicularis）或蛲虫（Oxiurus vermicularis）引起的盲肠阑尾蛲虫病。蛲虫病是一种世界性的寄生虫病[5,8,13]，且较为常见。确定其是否会引发阑尾炎以及相关机制很有必要。根据经典文献，蠕形住肠线虫本身并非阑尾炎的病原体，但会使侵入肠壁的细菌繁殖从而引发阑尾炎[5,9,10]。本研究的目的是报告外科手术切除的阑尾炎中蠕形住肠线虫的感染率，并通过解剖病理学来推断因果关系。我们报告了阿根廷科尔多瓦市急诊医院2000份（1992 - 2003年）手术切除阑尾样本的情况。在总共2000份样本中，我们观察到65例阑尾蛲虫病；其中60例（3.25%）没有急性炎症的组织病理学表现（无症状盲肠阑尾）。在其余5例（0.25%）中，我们观察到阑尾腔内存在寄生虫、急性透壁性炎症浸润（急性阑尾炎）和粪石，这支持了导致手术病变的梗阻型发病机制。蠕形住肠线虫在阑尾的寄生位置有利于粪石的形成以及肠壁内细菌的增殖，进而导致阑尾炎。报告表明，寄生虫感染在阑尾炎病因中占一定比例，粪石是最常见的诱因，一些寄生虫（如蠕形住肠线虫）可能参与其形成，尽管这一比例极小[9,10,15,16,17]。
