Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA.
Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA.
J Pediatr Surg. 2022 Aug;57(8):1494-1498. doi: 10.1016/j.jpedsurg.2021.09.038. Epub 2021 Oct 1.
Enterobius vermicularis is known to be associated with appendicitis, however a causal relationship between Enterobius and appendicitis has not been established. The aim of this study was to explore the relationship between appendiceal Enterobius and histologic appendicitis.
A retrospective review was performed of all pediatric appendectomies between 1997 and 2019. Patients with diagnosed with Enterobius were included for analysis. Patient demographics, operative findings, and pathologic reports were queried. Data were entered into an encrypted database and subsequently analyzed. A comprehensive review of the literature was also conducted.
Thirty-eight cases of Enterobius-associated appendicitis were identified out of 3541 (1.07%). Grossly normal appendices at operation were seen in 27% of patients. Inflammatory infiltrate was noted on histopathology in 78.3%, and Enterobius was considered to be the cause of that inflammation in 68.4%. The comprehensive literature review revealed 19 articles (1.87% incidence) that noted 35% of patients with appendiceal Enterobius had appendicitis on either histopathology or gross evaluation.
The high rate of inflammation on pathology found among our patients with pinworm appendicitis suggests an association with presentation as acute appendicitis. Our comprehensive review revealed a higher proportion of Enterobius appendicitis. Treatment with antihelminthic therapy is recommended.
LEVEL OF EVIDENCE (LOE): Level IV(4)-case series and comprehensive review.
众所周知，蛲虫与阑尾炎有关，但蛲虫和阑尾炎之间的因果关系尚未确定。本研究旨在探讨阑尾蛲虫与组织学阑尾炎之间的关系。
对 1997 年至 2019 年间所有小儿阑尾切除术进行回顾性分析。纳入诊断为蛲虫的患者进行分析。查询患者的人口统计学资料、手术发现和病理报告。数据输入加密数据库，然后进行分析。还进行了全面的文献复习。
在 3541 例（1.07%）中发现了 38 例蛲虫相关阑尾炎。术中发现阑尾大体正常的患者占 27%。组织病理学上观察到炎症浸润占 78.3%，68.4%认为蛲虫是导致该炎症的原因。全面的文献复习显示，19 篇文章（发病率 1.87%）指出，35%的蛲虫性阑尾炎患者在组织病理学或大体评估中存在阑尾炎。
我们的蛲虫性阑尾炎患者中，病理检查发现的高炎症率提示与急性阑尾炎表现有关。我们的综合审查显示蛲虫性阑尾炎的比例更高。建议采用驱虫治疗。
证据水平（LOE）：IV 级（4）-病例系列和综合回顾。
