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一名青少年患者的阑尾蛲虫病例。

A Case of Appendiceal Pinworms in an Adolescent Patient.

作者信息

Kauffman Zachary S, Stuart David L

机构信息

Research, Lincoln Memorial University - DeBusk College of Osteopathic Medicine, Beckley, USA.

General Surgery, Beckley Appalachian Regional Hospital, Beckley, USA.

出版信息

Cureus. 2025 Apr 21;17(4):e82714. doi: 10.7759/cureus.82714. eCollection 2025 Apr.

Abstract

While pinworm infections are common among children and adolescents, pinworms mimicking appendicitis are relatively rare. Notably, such manifestations may present in the absence of typical signs and symptoms of appendicitis. The appendix may even appear normal on a computed tomography (CT) scan and upon laparoscopic examination. The current case report aims to expand the literature on appendiceal pinworms while also showcasing the diagnostic challenge that such cases may represent. A 15-year-old female presented to the emergency department with acute onset of right lower quadrant abdominal pain and vomiting. Initial imaging studies, including CT of the abdomen and pelvis, revealed a normal-appearing appendix and gallbladder. Initial laboratory examinations revealed anemia; leukocytosis was notably absent. Despite the unremarkable findings, the severity of her pain continued to increase, leading to the decision to perform a diagnostic laparoscopy with appendectomy. The procedure was uncomplicated, and the removed appendix appeared grossly normal. However, histological examination of the appendix revealed intraluminal without transmural inflammation. Medical management of pinworm infestations is relatively simple. However, appendiceal pinworm infestations may not be diagnosed until surgical intervention has been employed. Case reports such as these offer insight into the diagnostic challenge that may be posed by appendiceal pinworms, emphasizing that high clinical suspicion may be needed to avoid unnecessary surgery.

摘要

虽然蛲虫感染在儿童和青少年中很常见,但蛲虫模仿阑尾炎的情况相对罕见。值得注意的是,这种表现可能在没有阑尾炎典型体征和症状的情况下出现。阑尾在计算机断层扫描(CT)和腹腔镜检查中甚至可能看起来正常。本病例报告旨在扩充关于阑尾蛲虫的文献,同时展示此类病例可能带来的诊断挑战。一名15岁女性因急性右下腹痛和呕吐就诊于急诊科。包括腹部和盆腔CT在内的初步影像学检查显示阑尾和胆囊外观正常。初步实验室检查显示贫血;白细胞增多症明显不存在。尽管检查结果无异常,但她的疼痛程度持续加重,导致决定进行诊断性腹腔镜阑尾切除术。手术过程顺利,切除的阑尾外观大体正常。然而,阑尾的组织学检查显示腔内无透壁炎症。蛲虫感染的药物治疗相对简单。然而,阑尾蛲虫感染可能直到采取手术干预才会被诊断出来。此类病例报告有助于深入了解阑尾蛲虫可能带来的诊断挑战,强调可能需要高度的临床怀疑以避免不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d28/12094811/96bc59b1cd1b/cureus-0017-00000082714-i01.jpg

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