Alshihmani Safaa Hadi Abdulsattar
Al-kindy Teaching Hospital, Department of Surgery, Baghdad, Iraq.
Ann Med Surg (Lond). 2022 Jul 8;80:104094. doi: 10.1016/j.amsu.2022.104094. eCollection 2022 Aug.
INTRODUCTION & IMPORTANCE: Enterobius vermicularis is the most common parasitic infection in developed countries of temperate and cool climates.The feco-oral route is the most common route of human infection. Due to obstruction of appendiceal lumen, the presence of parasites in the appendix may cause appendiceal colic or cause inflammation of the appendix.
A 17 years old male was referred to our Emergency Department with acute abdominal pain in his right lower quadrant. The physical and laboratory examination revealed right iliac fossa tenderness and leukocytosis with neutophilia. An open appendectomy was performed. The lumen of appendix was filled with pinworms and were moved out of the appendiceal lumen. Postoperatively, one oral dose of 100 mg of mebendazole was administered to our patient and his family members and was repeated after 14 days
Infrequently the E. vermicularis can be found in appendectomy pathological specimens. Rarely, acute appendicitis caused by parasitic infections, especially in adults. So the clinical signs of intestinal parasite infection can be may mimic acute appendicitis. A careful evaluation of symptoms such as pruritus ani, or eosinophilia on laboratory examination, could prevent unnecessary appendectomies.
蛲虫是温带和凉爽气候发达国家最常见的寄生虫感染。粪口途径是人类最常见的感染途径。由于阑尾腔阻塞,阑尾内存在寄生虫可能导致阑尾绞痛或引发阑尾炎。
一名17岁男性因右下腹急性腹痛被转诊至我们的急诊科。体格检查和实验室检查显示右下腹压痛以及白细胞增多伴中性粒细胞增多。进行了开放性阑尾切除术。阑尾腔内充满蛲虫,并将其从阑尾腔中取出。术后,给患者及其家属口服一剂100毫克甲苯达唑,并在14天后重复给药。
在阑尾切除病理标本中很少能发现蛲虫。寄生虫感染引起急性阑尾炎的情况很少见,尤其是在成年人中。因此,肠道寄生虫感染的临床症状可能会酷似急性阑尾炎。仔细评估诸如肛门瘙痒等症状,或实验室检查中的嗜酸性粒细胞增多情况,可避免不必要的阑尾切除术。