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蛲虫继发急性阑尾炎的诊断与手术干预:病例报告

Diagnosis and surgical intervention of acute appendicitis secondary to enterobius vermicularis: case report.

作者信息

Flores Uribe Alejandro, Pérez Macías Jorge Pablo, González Arévalo Jorge Alberto, Flores Uribe Oscar Armando

机构信息

General Surgery Department, Christus Muguerza Alta Especialidad Hospital, Monterrey, Nuevo León, Mexico.

General Surgery Department, Christus Muguerza Alta Especialidad Hospital, Monterrey, Nuevo León, Mexico.

出版信息

Int J Surg Case Rep. 2022 Oct;99:107678. doi: 10.1016/j.ijscr.2022.107678. Epub 2022 Sep 19.

Abstract

Acute appendicitis is the most common cause of acute abdominal pain in the pediatric population. The physiopathology is secondary to luminal obstruction of the appendix by several causes, among these, one of the rarest is due to parasitosis by Enterobius vermicularis in 0.005-3 %. We hereby present a case of a 10-year-old Latin male with abdominal pain with irradiation to right iliac fossa, nausea, vomiting and fever, following the national Mexican guides for ultrasound and blood tests were ordered, patient was treated with laparoscopic appendectomy with intraoperative finding of live helminths, which pathology examination revealed to be Enterovirus vermicularis. The patient has an uneventful postoperative course and was discharged after completing antiparasitic therapy. The lessons from this case are the importance of a good and quick diagnosis for acute abdomen in children, the possibility of a parasitic entity in the finding of eosinophilia with appendicitis and the good results with the correct surgical treatment.

摘要

急性阑尾炎是儿童急性腹痛最常见的原因。其病理生理是由多种原因导致阑尾管腔阻塞继发而来,其中最罕见的原因之一是蛲虫寄生虫感染,发生率为0.005%-3%。我们在此报告一例10岁拉丁裔男性患者,有腹痛并向右下腹放射,伴有恶心、呕吐和发热,按照墨西哥国家指南进行了超声检查并安排了血液检查,患者接受了腹腔镜阑尾切除术,术中发现活的蠕虫,病理检查显示为蛲虫。患者术后恢复顺利,完成抗寄生虫治疗后出院。该病例的经验教训包括对儿童急腹症进行准确快速诊断的重要性、阑尾炎伴嗜酸性粒细胞增多时存在寄生虫感染的可能性以及正确手术治疗可取得良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fb7/9568778/05de0d5fd3f3/gr1.jpg

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