1
|
Fantinatti M, Da-Cruz AM. Enterobius vermicularis in Brazil: An integrative review. Rev Soc Bras Med Trop 2023; 56:e00732023. [PMID: 37792827 PMCID: PMC10550099 DOI: 10.1590/0037-8682-0073-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/03/2023] [Indexed: 10/06/2023] Open
Abstract
Enterobius vermicularis, an intestinal helminth, is transmitted through the ingestion of eggs found in food, water, dust, or other fomites, including infected individuals. This review aimed to examine the frequency and distribution of E. vermicularis infections in Brazil between 1991 and 2022. The conducted bibliographic survey revealed that the frequency of E. vermicularis infections in Brazil ranged from 0.1 to 26.1%, depending on factors such as population ethnicity, individual age group, geographic area, time frame, and diagnostic method. However, these findings were based on a limited number of publications, suggesting that the actual prevalence rates of E. vermicularis infection may still be unknown and potentially underestimated.
Collapse
Affiliation(s)
- Maria Fantinatti
- Universidade Federal de Roraima, Curso de Medicina, Boa Vista, RR, Brasil
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
| | - Alda Maria Da-Cruz
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Laboratório Interdisciplinar de Pesquisas Médicas, Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Disciplina de Parasitologia, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
2
|
An Evaluation of the Efficacy of Systemic Immune-Inflammation Index in Predicting Enterobius-Associated Appendicitis Preoperatively. Cureus 2023; 15:e36733. [PMID: 36992816 PMCID: PMC10041780 DOI: 10.7759/cureus.36733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
Objective Our study aimed to retrospectively evaluate Enterobius-associated appendicitis cases and compare them with acute appendicitis cases in terms of parameters such as the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP)-to-lymphocyte ratio (CLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). We primarily aimed to evaluate the utility of SII in the differential diagnosis of Enterobius-associated appendicitis. Methods The appendectomy specimens of pediatric patients who were operated on for acute appendicitis between June 2016 and August 2022 were retrospectively evaluated. Enterobius-associated appendicitis cases were included for analysis. All patients were evaluated regarding age, gender, blood count, surgery, and pathology reports. Pathology reports were evaluated for the presence of histological signs of acute appendicitis. The patients were classified into an Enterobius-associated appendicitis group and a regular acute appendicitis group. CRP, white blood cell (WBC), red cell distribution width (RDW), neutrophils, lymphocytes, NLR, monocytes, eosinophils, platelet (PLT), PLR, CLR, and SII values were compared between the two groups. Results Eleven cases of Enterobius-associated appendicitis were identified out of 430 total cases (2.55%) examined. The mean age of the group with acute appendicitis was 12.83 ±3.16 years, while the mean age of the group with Enterobius-associated appendicitis was 8.55 ±2.54 years. There was no statistically significant difference in terms of CRP, WBC, RDW, lymphocytes, neutrophils, NLR, monocytes, eosinophils, PLT, PLR, and CLR values between the two groups (p>0.05). However, when the SII values of the participants were analyzed, it was observed that the SII values of the participants in the regular appendicitis group were significantly higher than those of the participants in the Enterobius group (p<0.05). Among the 11 Enterobius-associated appendicitis patients, seven appendectomy specimens revealed no inflammation and were regarded as negative appendectomy (63.63%). Conclusion This is the first study to demonstrate the utility of preoperative SII evaluation in Enterobius-associated appendicitis. SII is a simple, easy-to-calculate indicator of Enterobius-associated appendicitis and aids in the preoperative differential diagnosis of acute appendicitis.
Collapse
|
3
|
Sousa J, Hawkins R, Shenoy A, Petroze R, Mustafa M, Taylor J, Larson S, Islam S. Enterobius vermicularis-associated appendicitis: A 22-year case series and comprehensive review of the literature. J Pediatr Surg 2022; 57:1494-1498. [PMID: 34756582 DOI: 10.1016/j.jpedsurg.2021.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION 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. METHODS 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. RESULTS 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. CONCLUSION 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.
Collapse
Affiliation(s)
- John Sousa
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Russell Hawkins
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Archana Shenoy
- Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Robin Petroze
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Moiz Mustafa
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Janice Taylor
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Shawn Larson
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA
| | - Saleem Islam
- Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Road, PO Box 100119, Gainesville, FL 32610, USA.
| |
Collapse
|
4
|
Castañeda C, Valbuena D, Salamanca W, Acevedo D, Pedraza M. Case Report: Laparoscopic Management of Acute Appendicitis Resulting from Ascaris lumbricoides. Am J Trop Med Hyg 2022; 107:130-131. [PMID: 35895367 PMCID: PMC9294670 DOI: 10.4269/ajtmh.21-1245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/28/2022] [Indexed: 10/03/2023] Open
Abstract
Appendicitis is one of the most common conditions that leads to an acute abdomen. Surgical management is the gold standard for therapy. The main cause of appendicitis is an obstruction in the appendicular lumen. Intestinal ascariasis infection is undoubtedly one of the least frequent. We present a female patient with acute appendicitis resulting from Ascaris lumbricoides as an incidental intraoperative diagnosis.
Collapse
Affiliation(s)
| | - Diego Valbuena
- Department of General Surgery, Hospital La Samaritana, Bogota, Colombia
| | - William Salamanca
- Department of General Surgery, Hospital La Samaritana, Bogota, Colombia
| | - David Acevedo
- Department of Medicine, El Bosque University, Bogota, Colombia
| | - Mauricio Pedraza
- Department of General Surgery, El Bosque University, Bogota, Colombia
| |
Collapse
|
5
|
Eslahi AV, Olfatifar M, Houshmand E, Abdoli A, Bijani B, Hashemipour S, Mahmoudi R, Hajialilo E, Javad Abbaszadeh Afshar M, Mohammadzadeh AR, Badri M. Parasites in surgically removed appendices as a neglected public health concern: a systematic review and meta-analysis. Pathog Glob Health 2021; 116:341-355. [PMID: 34842078 DOI: 10.1080/20477724.2021.2008701] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The role of various parasitic infections in the occurrence of appendicitis is illustrated through cases recorded all over the world. The purpose of the current study was to estimate the global prevalence of parasite infestation (other than E. vermicularis) in appendectomy specimens.In the setting of the PRISMA guidelines, multiple databases (Science Direct, Scopus, Web of Science, PubMed, and Google Scholar) were explored in articles published until 28 September 2020. Totally, 62 studies (106 datasets) with 77, 619 participants were included in the analysis.The pooled prevalence of parasites in appendectomy samples was as follows; 0.012% (95% CI; 0.004-0.025) for Ascaris lumbricoides, 0.004% (95% CI; 0.001-0.009) for Trichuris trichiura, 0.025% (95% CI; 0.007-0.052) for Schistosoma mansoni, 0.002% (95% CI; 0.001-0.005) for Taenia spp., 0.061% (95% CI; 0.020-0.122) for Entamoeba histolytica and 0.034% (95% CI; 0.018-0.056) for Giardia lamblia.Our results demonstrated that the risk of appendicitis may increase in the presence of helminth and protozoan infections. As such, the most cases of parasites in appendectomy specimens were reported in developing countries. Regular screening plans for diagnosis, treatment and prevention are needed for prevention of parasitic infection as well as parasitic associated appendicitis, especially in endemic regions of the world.
Collapse
Affiliation(s)
- Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Meysam Olfatifar
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Houshmand
- Department of Parasitology, Faculty of Veterinary Medicine, Rasht Branch, Islamic Azad University, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Behzad Bijani
- Clinical Research Development Unit, Kosar Hospital, Qazvin University Of Medical Sciences, Qazvin, Iran
| | - Sima Hashemipour
- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Razzagh Mahmoudi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Elham Hajialilo
- Department of Parasitology and Mycology, Qazvin University of Medical Sciences, Qazvin, Iran.,Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Ali Reza Mohammadzadeh
- Clinical Research Development Unit, Qods Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| |
Collapse
|
6
|
Sharifdini M, Nematdoost K, Shafiei R, Teimouri A. Acute eosinophilic appendicitis caused by Taenia saginata: A case report. Ann Med Surg (Lond) 2021; 64:102241. [PMID: 33868681 PMCID: PMC8040111 DOI: 10.1016/j.amsu.2021.102241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction The role of parasites in the pathogenesis of appendicitis has been debated for a long time. To date, several gastrointestinal parasites have been reported as the causes of appendicitis in humans. Taenia infestation of the appendix is uncommon and few cases have been reported in the literature. Presentation of case We reported a case of acute eosinophilic appendicitis (AEA) in a 42-year-old woman caused by T. saginata in northern Iran. The patient was admitted to the emergency department with a 2-day history of acute abdominal pain in her lower right quadrant. Abdominal ultrasonography showed intra-abdominal bleeding and endometrium cysts. Routine hematological tests showed increases in white blood cell (WBC) count of 19.8 × 103 per mcL with 3% eosinophilia. During abdominal laparotomy, peritoneal fluid was bulked with abdominal bleeding due to rupture of the uterine cyst. After investigation of inflammation in the appendix region, patient underwent appendectomy. Histopathological findings showed acute inflammation with eosinophils and a large number of round eggs with flattened segments of the genus Taenia. It is impossible to distinguish between T. saginata and T. solium based solely on egg morphology in the specimens. Therefore, based on history of the patient, which included no consumption of pork, the species was identified as T. saginata. At the three months follow-up, the patient was in good health. Conclusion In the current study, a case of AEA by T. saginata was reported. However, this was not the first case of acute appendicitis by T. saginata. Further studies are necessary to show roles of parasites in pathogenesis of AEA. T. saginata is distributed globally, and more frequent in developing countries. Taenia infestation of the appendix is uncommon and few cases have been reported in the literature. In the current study, a case of acute eosinophilic appendicitis caused by T. saginata was reported.
Collapse
Affiliation(s)
- Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Khadijeh Nematdoost
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Shafiei
- Department of Pathobiology and Laboratory Sciences, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Aref Teimouri
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Hasan A, Nafie K, El-Sayed S, Nasr M, Abdulmohaymen A, Baheeg M, Abbadi O. Enterobius vermicularis in appendectomy specimens; Clinicopathological assessment: Cross sectional study. Ann Med Surg (Lond) 2020; 60:168-172. [PMID: 33149902 PMCID: PMC7599363 DOI: 10.1016/j.amsu.2020.10.057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/25/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study identifies the incidence of appendiceal Enterobius vermicularis (E.v) infestation in all the patients undergoing appendectomy and evaluates the relationship between E. v infestation of the appendix and the acute appendicitis. METHOD ology: All the routinely examined appendectomy specimens received in the pathology laboratory of a referral hospital over a three year period of time were reviewed for the existence of E. v. These cases were evaluated for clinico-laboratory characterization. RESULTS Out of 1150 appendectomies for clinical acute appendicitis picture, 31 (2.7%) cases revealed E. v infestation. The age ranged from 6 to 42 years old but more than 80% of the E. v infected cases were children. Twenty four cases (77.4%) did not show any other appendiceal pathology, six cases showed lymphoid hyperplasia and only one case showed concomitant histological acute inflammatory process. CONCLUSION E. v infestation is an incidental finding during histopathology examination of appendectomy specimens for patients with clinical diagnosis of acute appendicitis, however there is no relation between the existence of E. v and occurrence of acute appendicitis which is the main indication for appendectomy, so further studies are recommended to reach out earlier diagnosis to eliminate the unnecessary surgical intervention. Also surgeons should consider E. v as a differential diagnosis when removing a normal looking appendix to take the necessary precautions for minimizing any chance of contamination and sending all the normal looking appendectomy specimens for histopathology examination.
Collapse
Affiliation(s)
- Abdulkarim Hasan
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
| | - Khalid Nafie
- Laboratory & Blood Bank Department, Prince Mishari Bin Saud Hospital, Baljurashi, Saudi Arabia
| | - Samar El-Sayed
- Department of Parasitology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mohamed Nasr
- Department of Histology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ayman Abdulmohaymen
- Department of Surgical Oncology Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Baheeg
- Department of Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Osama Abbadi
- Department of Biochemistry, Faculty of Medicine, Omdurman Islamic University, Sudan
| |
Collapse
|
8
|
Sarici B, Akbulut S, Ozcan M, Demyati K, Samdanci E. Unusual infectious agents detected in appendectomy specimens: A retrospective analysis of 42 cases. Turk J Surg 2020; 36:291-296. [PMID: 33778385 PMCID: PMC7963316 DOI: 10.47717/turkjsurg.2020.4713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/24/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical and histopathological features of 42 patients with unusual infectious agents detected in their appendectomy specimens. MATERIAL AND METHODS Between January 1999 and November 2018, 2.754 patients underwent emergency or incidental appendectomy in our clinic, and their pathology reports were retrospectively reviewed. Unusual infectious agents or eosinophilic infiltration of the appendix were reported in the initial pathological examinations of 57 patients. The pathological slides of these patients were re-examined by histopathologists. The examinations revealed that 15 of these patients had no microscopic findings suggestive of parasitic infections. The remaining 42 patients with unusual appendiceal infectious agents were included into the study. RESULTS A total of 42 patients (25 females and 17 males) aged 18 to 75 years were included into this study. While 32 of these patients (76%) underwent emergency appendectomy with a presumed diagnosis of acute appendicitis (AAp), the remaining 10 patients underwent incidental appendectomy for various reasons. Twenty-two patients (52.4%) had histopathological changes consistent with AAp while 20 patients had no evidence of AAp. Histopathological examination revealed infection with Enterobius vermicularis in 38 of the patients, Taenia species in 2, and Ascaris lumbricoides and Actinomyces species in 1 patient each. A total of 24 patients were treated for infections with mebendazole (n = 20), albendazole (n =1), niclosamide (n = 2), and amoxicillin (n = 1). CONCLUSION Unusual infectious agents should be considered as factors potentially triggering AAp, especially in patients living in endemic areas. The appendiceal stump should be inspected for parasite residues.
Collapse
Affiliation(s)
- Baris Sarici
- Inonu University Faculty Of Medicine, Surgery, Malatya, Turkey
| | - Sami Akbulut
- Inonu University Faculty Of Medicine, Surgery, Malatya, Turkey
| | - Mehmet Ozcan
- Inonu University Faculty Of Medicine, Patholgoy, Malatya, Turkey
| | - Khaled Demyati
- An-najah National University, Suegery, Nablus, Palestinian Territories
| | - Emine Samdanci
- Inonu University Faculty Of Medicine, Patholgoy, Malatya, Turkey
| |
Collapse
|
9
|
Chitnis A, Yousefi Azimi D, Sabri S, Dhebri A. Enterobius Vermicularis: A Parasitic Cause of Appendicular Colic. Cureus 2020; 12:e8524. [PMID: 32656037 PMCID: PMC7346307 DOI: 10.7759/cureus.8524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Enterobius vermicularis is the most commonly identified parasite incidentally found within the appendix of a clinically diagnosed appendicitis. This parasitic cause of appendicular colic, primarily affecting children, is an important cause of negative appendicectomy. We report an unusual and interesting case of a young female who presented with clinical features of acute appendicitis. Laparoscopic appendicectomy revealed the presence of an Enterobius vermicularis infestation originating from the lumen of her vermiform appendix. Our case report is supplemented with a review of the literature, an overview of the parasitology, and discussion of pertinent symptomatology and peri-operative management strategies.
Collapse
Affiliation(s)
| | | | - Shariq Sabri
- General Surgery, Tameside General Hospital, Manchester, GBR
| | - Alhad Dhebri
- General Surgery, Tameside General Hospital, Manchester, GBR
| |
Collapse
|
10
|
The neglected role of Enterobius vermicularis in appendicitis: A systematic review and meta-analysis. PLoS One 2020; 15:e0232143. [PMID: 32324817 PMCID: PMC7179856 DOI: 10.1371/journal.pone.0232143] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/07/2020] [Indexed: 01/13/2023] Open
Abstract
Although the main cause of appendicitis is unclear, infection with Enterobius vermicularis is suggested as a neglected risk factor. Since, there is no comprehensive analysis to estimate the prevalence of E. vermicularis in appendicitis; therefore, we conducted a global-scale systematic review and meta-analysis study to estimate the prevalence of E. vermicularis infection in appendicitis cases. PubMed, Scopus, Web of Science and Google Scholar databases were systematically searched for relevant studies published until 15 August 2019. Pooled prevalence of E. vermicularis infection was estimated using the random effects model. Data were classified based on the continents and countries. Moreover, subgroup analyses regarding the gender, the human development index (HDI), and income level of countries were also performed. Fifty-nine studies involving 103195 appendix tissue samples belonging to the individuals of appendicitis were included. The pooled prevalence of E. vermicularis infection was (4%, 95%CI, 2–6%), with the highest prevalence (8%, 95% CI: 0–36%) and lowest prevalence (2%, 95% CI: 1–4%) in Africa and Americas continents, respectively. With respect to countries, the lowest and highest prevalence rates were reported from Venezuela (<1%, 95% CI: 0–1%) and Nigeria (33%, 95% CI: 17–52%), respectively. Indeed, a higher prevalence was observed in females, as well as in countries with lower levels of income and HDI. Our findings indicate the relatively high burden of E. vermicularis infection in appendicitis cases. However, our findings suggest the great need for more epidemiological studies to depth understand overlaps between E. vermicularis infection and appendicitis in countries with lower HDI and income levels.
Collapse
|
11
|
Review of Appendicitis in Patients With Prolonged Neutropenia. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2018. [DOI: 10.1097/ipc.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Amer AS, Saad AE, Antonios SN, Hasby EA. Prevalence of Parasitic Infections in Surgically Removed Appendices: Parasitological and Histopathological Studies. Helminthologia 2018; 55:33-44. [PMID: 31662625 PMCID: PMC6799533 DOI: 10.1515/helm-2017-0056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/15/2017] [Indexed: 02/05/2023] Open
Abstract
Intestinal parasites may cause symptoms similar to acute appendicitis. Moreover, the diagnosis of parasitic infections is only done by post-operative histopathological examination of the appendices. Therefore, our aims are to assess the prevalence of intestinal parasitic infections among patients who were be appendectomized at Tanta Hospitals, Egypt and to investigate the possible association between these parasitic infections and appendicitis. To achieve these objectives, we performed a cross-sectional study including 65 patients chosen randomly who had undergone appendectomy over a period of one year from Oct 2015 to Oct 2016. Demographic data were retrieved. Complete blood picture was done. Moreover, appendiceal faecolith were examined macroscopically then by direct smear examination, formol-ether concentration technique, modified Ziehl-Nelseen stain and rapid immunochromatographic test. Histopathological examination of resected appendices was done. We found that parasitic infections were detected in 24.6 % of examined cases. Most of parasitic infections were prevalent in patients belonging to the school age group. Different parasitic infections were detected in the faecolith specimens. Moreover, Enterobious vermicularis adult female and Schistosoma mansoni granuloma were detected in histopathological sections. Also, a spectrum of pathological changes in the appendices was found ranging from lymphoid hyperplasia to acute inflammation with peritonitis. In conclusion, intestinal parasites may cause clinical picture similar to that of acute appendicitis. Therefore, careful attention to clinical history, stool examination and high eosinophilia may aid diagnosis and avoid unnecessary appendectomy. Moreover, the presence of different parasitic stages in the narrow lumen of the appendix may have a role in the development of appendicitis and this needs further studies.
Collapse
Affiliation(s)
- A. S. Amer
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - A. E. Saad
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - S. N. Antonios
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - E. A. Hasby
- Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
| |
Collapse
|
13
|
Altun E, Avci V, Azatcam M. Parasitic infestation in appendicitis. A retrospective analysis of 660 patients and brief literature review. Saudi Med J 2017; 38:314-318. [PMID: 28251230 PMCID: PMC5387911 DOI: 10.15537/smj.2017.3.18061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the incidence of parasitic infestations and inflammation accompanying parasitosis in a series of appendectomy cases. Methods: Six-hundred-sixty patients who had undergone appendectomy in Bingöl State Hospital, Bingol, Turkey with the preliminary diagnosis of appendicitis between January 2012 and February 2015 were included in this retrospective study. They were retrospectively evaluated in terms of age, gender and pathological findings. Cases diagnosed with parasitic infestations were re-evaluated histopathologically for inflammatory response. Results: The mean age was 19.6 years, and the male/female ratio was 1.8. When evaluated in terms of histopathological diagnoses, 573 (86.8%) were diagnosed as acute appendicitis, and parasitic infestation was identified in 12 (1.8%). Among cases with parasitic infestation, Enterobius vermicularis was identified in 9 (75%) and Taenia in 3 (25%) cases. Of cases with Enterobius vermicularis, 4 (44.4%) had lymphoid hyperplasia, 1 (11.1%) had normal-structured appendix vermiformis, and 4 (44.4%) had findings of acute appendicitis. All cases with taeniasis had an inflammatory response: acute appendicitis was identified in 2 (66%) and acute gangrenous appendicitis in 1 (33%) of them. Conclusion: Parasitic infestations are among the probable causes in appendicitis etiology and should be kept in mind during differential diagnosis. However, whether every parasitic infestation leads to appendiceal inflammatory response is controversial.
Collapse
Affiliation(s)
- Eren Altun
- Medical Pathology Department, Faculty of Medicine, University of Balikesir, Balikesir, Turkey. E-mail.
| | | | | |
Collapse
|
14
|
Lala S, Upadhyay V. Enterobius vermicularis and its role in paediatric appendicitis: protection or predisposition? ANZ J Surg 2016; 86:717-9. [PMID: 26990375 DOI: 10.1111/ans.13464] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND E nterobius vermicularis is one of the most common parasitic infections of the gastrointestinal tract, and has been shown to infest up to 28% of children worldwide. The role of E . vermicularis in acute appendicitis has previously been questioned, with some studies identifying infection as a precursor for inflammation of the appendix, with others refuting such a link. METHODS A retrospective review was conducted of all appendices received for histological analysis at our unit from January 2002 to December 2011 (10-year period), removed in the course of acute appendicectomy in children aged 3 to 15 years. Appendices were categorized by degree of inflammation and infestation with E . vermicularis. RESULTS Appendicectomy for clinical suspicion of acute appendicitis was performed in 2923 patients, 1694 (58%) male, median age 11.6 years. E . vermicularis was present in 4% of appendices; 25% of which showed concurrent acute inflammation. E . vermicularis infestation was more common in females (F : M 76% versus 24% of inflamed appendices and 66.7% versus 33.3% for non-inflamed appendices). European individuals showed higher representation in the E . vermicularis group than the total study population (79% versus 53% respectively). CONCLUSION E . vermicularis was found to be more common in females and those of European descent. Seventy-seven percent of patients with E . vermicularis did not have concurrent acute inflammation of the appendix on histological examination. The question remains as to whether infestation is protective of inflammation or whether infestation causes appendiceal colic and subsequent appendicectomy of a non-inflamed appendix, thereby protective of the morbidity of acute appendicitis.
Collapse
Affiliation(s)
- Shareena Lala
- Department of Paediatric Surgery and Urology, Starship Children's Health, Auckland, New Zealand
| | - Vipul Upadhyay
- Department of Paediatric Surgery and Urology, Starship Children's Health, Auckland, New Zealand
| |
Collapse
|
15
|
Iguchi S, Hirai Y, Ainoda Y, Isoda N, Miura H, Egawa H, Yamamoto M, Kikuchi K. Incidental diagnosis of oxyuriasis through a colonoscopy. IDCases 2016; 4:38-40. [PMID: 27077026 PMCID: PMC4816899 DOI: 10.1016/j.idcr.2016.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 02/27/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Shigekazu Iguchi
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan
- Corresponding author at: Department of Infectious Diseases, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Tel.: +81 3 3353 8111x38311; fax: +81 3 5269 7003.Department of Infectious Diseases, Tokyo Women's Medical University8-1 Kawada-cho, Shinjuku-kuTokyo162-8666Japan
| | - Yuji Hirai
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yusuke Ainoda
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan
| | - Noriko Isoda
- Department of Clinical Laboratory, Tokyo Women's Medical University, Tokyo, Japan
| | - Hitomi Miura
- Department of Clinical Laboratory, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroto Egawa
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Masakazu Yamamoto
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan
| |
Collapse
|
16
|
Hamdona SM, Lubbad AM, Al-Hindi AI. Histopathological study of Enterobius vermicularis among appendicitis patients in Gaza strip, Palestine. J Parasit Dis 2016; 40:176-83. [PMID: 27065621 PMCID: PMC4815832 DOI: 10.1007/s12639-014-0472-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 05/08/2014] [Indexed: 11/30/2022] Open
Abstract
Enterobius vermicularis is one of the most common intestinal parasite in human. The main objective of this study is to determine the role of E. vermicularis in appendicitis through histopathological examination. A cross sectional study included 200 patients who had appendectomy from three hospitals in Gaza strip. The inflamed appendix was the cause of attending the hospital. Histopathological examination for each appendix was carried out. A questionnaire was designed (interview with patients who underwent appendectomy), and information were obtained from patient and analyzed by using SPSS. The study showed that 30 (15.0 %) of 200 appendices had E. vermicularis in histopathological examination. It was found that ages of patients with histologically proven E. vermicularis in appendices less than 18 years old was found to be (18.2 %). Regarding sex, (16.5 %) of females, (14.0 %) of males patients had E. vermicularis in appendices. Patients who had the highest infection with E. vermicularis were students (17.3 %). In conclusion E. vermicularis occurs more frequently inflamed appendices than in normal. From these results we can conclude that E. vermicularis could be associated to cause of appendicitis in Gaza strip.
Collapse
Affiliation(s)
| | - Abdel Monem Lubbad
- />Faculty of Medicine, Islamic University of Gaza, P.O. Box 108, Gaza, Palestine
| | - Adnan I. Al-Hindi
- />Medical Laboratory Sciences Department, Faculty of Health Sciences, Islamic University of Gaza, P.O. Box 108, Gaza, Palestine
| |
Collapse
|
17
|
Paknazhad N, Mowlavi G, Dupouy Camet J, Jelodar ME, Mobedi I, Makki M, Kia EB, Rezaeian M, Mohebali M, Sarlak S, Najafi F. Paleoparasitological evidence of pinworm (Enterobius vermicularis) infection in a female adolescent residing in ancient Tehran (Iran) 7000 years ago. Parasit Vectors 2016; 9:33. [PMID: 26797296 PMCID: PMC4722758 DOI: 10.1186/s13071-016-1322-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Molavi street archeological site south of Tehran accidentally provided a unique opportunity for paleoparasitological studies in Iran. A female skeleton was unearthed and evaluated to be 7000 years old. Soil samples were collected around the pelvic and sacrum bones. FINDINGS Careful microscopic investigation of rehydrated soil samples revealed the presence of one Enterobius vermicularis egg attached to the skeleton sacral region. CONCLUSION The present finding likely represents the oldest evidence of a human pinworm infection in Asia.
Collapse
Affiliation(s)
- Niloofar Paknazhad
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Gholamreza Mowlavi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Jean Dupouy Camet
- Service de Parasitologie-Mycologie, Hôpital Cochin Assistance Publique Hôpitaux de Paris, Université Paris Descartes, 27 Faubourg St Jacques, 75014, Paris, France.
| | | | - Iraj Mobedi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mahsasadat Makki
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Eshrat Beigom Kia
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mostafa Rezaeian
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Mohebali
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran.
| | - Siamak Sarlak
- Member of Iranian Center for Archaeological Research, Siye Tir Street, Imam Khomeini Avenue, Tehran, Iran.
| | - Faezeh Najafi
- Department of Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
18
|
Akkapulu N, Abdullazade S. Is Enterobius vermicularis infestation associated with acute appendicitis? Eur J Trauma Emerg Surg 2015; 42:465-470. [PMID: 26250824 DOI: 10.1007/s00068-015-0555-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 07/31/2015] [Indexed: 01/15/2023]
Abstract
PURPOSE Enterobius vermicularis might be seen in specimens of patients who underwent surgery due to acute appendicitis. There is still debate as to E. vermicularis infestation causes acute appendicitis. The primary aim of this study is to determine the incidence of E. vermicularis infestation, and the secondary aim is to determine the possible role of E. vermicularis in pathogenesis of appendicitis as well as the adequacy of demographic data and laboratory values in predicting infestation preoperatively. METHODS A retrospective investigation was conducted with all patients who underwent appendectomy due to acute appendicitis in a secondary care center. Patients with E. vermicularis were compared with 24 controls that underwent appendectomy during the same time period. Demographic data, preoperative white blood cell (WBC) count, eosinophil counts, and histopathological findings for both groups were analyzed and compared. RESULTS Enterobius vermicularis was detected in the appendectomy materials in 9 of 1446 patients (0.62 %). Histopathologically, only one of nine patients had acute appendicitis while the others were diagnosed with lymphoid hyperplasia. There were no statistically significant differences between the groups except WBC count. However, the WBC count was significantly (p < 0.05) lower in the group which was detected E. vermicularis. CONCLUSIONS Enterobius vermicularis is rarely associated with the histopathological findings of acute appendicitis. Also eosinophil count and elevation of white blood counts are inadequate for predicting preoperative E. vermicularis.
Collapse
Affiliation(s)
- N Akkapulu
- General Surgery Department of Mus State Hospital, Mus, Turkey. .,Bahcelievler mh. Yunus Emre, cd no: 8/3 52200, Ordu, Turkey.
| | - S Abdullazade
- Pathology Department of Mus State Hospital, Mus, Turkey
| |
Collapse
|
19
|
Fleming CA, Kearney DE, Moriarty P, Redmond HP, Andrews EJ. An evaluation of the relationship between Enterobius vermicularis infestation and acute appendicitis in a paediatric population--A retrospective cohort study. Int J Surg 2015; 18:154-8. [PMID: 25771103 DOI: 10.1016/j.ijsu.2015.02.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/07/2015] [Accepted: 02/15/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Enterobius vermicularis is an often unexpected finding in appendectomy specimen, most commonly seen in paediatric cases. Predicting the presence of E. vermicularis in the setting of appendectomy is important to avoid unnecessary appendectomy and associated morbidity. We sought to identify the incidence of E. vermicularis in a paediatric population undergoing appendectomy for clinically suspected acute appendicitis and identify predictive factors for E. vermicularis. METHODS This study was performed in an 800-bed University Teaching Hospital, in the Republic of Ireland. We identified all paediatric appendectomies performed at our institute from January to December 2012 using prospectively maintained operating theatre logbooks. In-hospital Histopathology database, medical notes and operative findings were reviewed for each patient and relevant data recorded. Statistical analysis was performed using IBM SPSS, version 21. RESULTS In total 182 paediatric appendectomies were performed during the year 2012 for clinically suspected acute appendicitis. Demographics included: Mean age 11.14 years (3-16), gender 1M: 1F. 58.8% of procedures were completed laparoscopically, 39% open and 2.2% were converted. The negative appendectomy rate was 22.5%. The annual incidence of E. vermicularis in acute appendicitis specimen from a paediatric cohort at our institute was 7% (1 in 14). In specimen containing E. vermicularis, 69% had no evidence of appendicitis and of those that had, no gangrene or perforation was seen. The presence of E. vermicularis in paediatric patients with RIF pain may be predicted by Eosinophilia (p = 0.016), normal WCC (p = 0.034) and normal Neutrophil count (p = 0.014). CONCLUSIONS E. vermicularis is responsible for 7% of acute appendicitis. It is responsible for a significantly higher negative appendectomy rate which if predicted may avoid unnecessary appendectomy and associated morbidity.
Collapse
Affiliation(s)
- C A Fleming
- Department of General Surgery, Cork University Hospital, Cork, Ireland.
| | - D E Kearney
- Department of General Surgery, Cork University Hospital, Cork, Ireland; Department of Colorectal Surgery, Cork University Hospital, Cork, Ireland
| | - P Moriarty
- Department of General Surgery, Cork University Hospital, Cork, Ireland
| | - H P Redmond
- Department of General Surgery, Cork University Hospital, Cork, Ireland
| | - E J Andrews
- Department of General Surgery, Cork University Hospital, Cork, Ireland; Department of Colorectal Surgery, Cork University Hospital, Cork, Ireland
| |
Collapse
|
20
|
Ahmed MU, Bilal M, Anis K, Khan AM, Fatima K, Ahmed I, Khatri AM, Shafiq-ur-Rehman. The Frequency of Enterobius Vermicularis Infections in Patients Diagnosed With Acute Appendicitis in Pakistan. Glob J Health Sci 2015; 7:196-201. [PMID: 26156929 PMCID: PMC4803892 DOI: 10.5539/gjhs.v7n5p196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 01/19/2015] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION The main aim of this study was to determine the frequency of Enterobius vermicularis infections and other unique histopathological findings in patients diagnosed with acute appendicitis. MATERIALS This retrospective study was conducted in a tertiary care hospital of Karachi, Pakistan over a time period of 9 years from 2005 to 2013. The recorded demographic and histopathological data for the 2956 appendectomies performed during this time frame were extracted using a structured template form. Negative and incidental appendectomies were excluded from the study. RESULTS Out of the 2956 patients diagnosed with acute appendicitis, 84 (2.8%) patients had Enterobius vermicularis infections. Malignancy (n=2, 0.1%) and infection with Ascaris (n=1, 0.1%) was found very rarely among the patients.Eggs in lumen (n=22, 0.7%), mucinous cystadenoma (n=28, 1.0%), mucocele (n=11, 0.4%), lymphoma (n=9, 0.3%), obstruction in lumen (n=17, 0.6%) and purulent exudate (n=37, 1.3%) were also seldom seen in the histopathological reports. CONCLUSION Enterobius vermicularis manifestation is a rare overall but a leading parasitic cause of appendicitis. Steps such as early diagnosis and regular de worming may help eradicate the need for surgeries.
Collapse
|
21
|
Alemayehu H, Snyder CL, St Peter SD, Ostlie DJ. Incidence and outcomes of unexpected pathology findings after appendectomy. J Pediatr Surg 2014; 49:1390-3. [PMID: 25148744 DOI: 10.1016/j.jpedsurg.2014.01.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/13/2013] [Accepted: 01/12/2014] [Indexed: 01/25/2023]
Abstract
PURPOSE Pathologic evaluation of the appendix after appendectomy is routine and can identify unexpected findings. We evaluated our experience in children undergoing appendectomy to review the clinical course of patients with unexpected appendiceal pathology. METHODS After IRB approval, a retrospective review was conducted on patients who underwent appendectomy from January 1, 1995 to March 1, 2011. Patient demographics, diagnosis, pathological findings, disease outcomes, and treatment were collected only on patients with abnormal pathology. RESULTS 3602 patients underwent appendectomy. 113 patients had normal appendices, and 86 patients had unexpected findings, including carcinoid tumor (n=9), pinworm (n=34), granuloma (n=14), eosinophilic infiltrates (n=18), and other (n=11). All cases of carcinoid tumor were completely resected, with no recurrence or need for reoperation. Of the 34 patients with pinworm infestation, 41.2% underwent antimicrobial therapy, and none had post-operative symptoms. One patient (7%) with an appendiceal granuloma developed Crohn's disease. Three patients (16.7%) with eosinophilia developed symptomatic intestinal eosinophilia. CONCLUSIONS Pediatric appendiceal carcinoid is an incidental finding; in this series, none required further intervention. Appendiceal granulomas are not commonly associated with developing Crohn's disease in the short term. Routine antibiotics for the treatment of pinworms are adequate. Patients with appendiceal eosinophilia may develop symptomatic intestinal eosinophilia.
Collapse
|
22
|
Kaczynski J, Hilton J. An 'appendiceal colic' caused by the Enterobius vermicularis. BMJ Case Rep 2014; 2014:bcr-2013-202962. [PMID: 24722714 DOI: 10.1136/bcr-2013-202962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jakub Kaczynski
- General Surgery Department, Dumfries and Galloway Royal Infirmary, Dumfries, UK
| | | |
Collapse
|
23
|
Yabanoglu H, Caliskan K, Ozgur Aytac H, Turk E, Karagulle E, Kayaselcuk F, Akin Tarim M. Unusual findings in appendectomy specimens of adults: retrospective analyses of 1466 patients and a review of literature. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e12931. [PMID: 24719727 PMCID: PMC3965860 DOI: 10.5812/ircmj.12931] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/29/2013] [Accepted: 08/23/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis. OBJECTIVES This retrospective study was conducted to document the unusual findings in appendectomy specimens. PATIENTS AND METHODS Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients' age, gender, clinical presentations, operative reports, pathological reports and follow up. RESULTS Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 ± 19. Twenty-nine patients (50.8 %) were male and 28 (49.2 %) were female. Normal appendix tissues were observed in specimens of 26 (45.6 %) patients and inflamed appendix in 31 (54.3 %). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology. CONCLUSIONS Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.
Collapse
Affiliation(s)
- Hakan Yabanoglu
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Kenan Caliskan
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Huseyin Ozgur Aytac
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Emin Turk
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Erdal Karagulle
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
- Corresponding Author: Erdal Karagulle, Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey. Tel: +90-03322570606, Fax: +90-03322570637, E-mail:
| | - Fazilet Kayaselcuk
- Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Mehmet Akin Tarim
- Department of General Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey
| |
Collapse
|
24
|
Buyukbese Sarsu S, Ucak R, Buyukbese MA, Karakus SC, Deniz H. Unusual Histopathological Findings in Childhood Appendectomy Specimens. Indian J Surg 2013; 77:594-9. [PMID: 26730070 DOI: 10.1007/s12262-013-0934-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/10/2013] [Indexed: 01/07/2023] Open
Abstract
The purpose of this study was to find the unusual findings in the childhood appendectomy specimens and their incidence. The clinicopathological data of 1,306 patients whose ages ranged from 3 to 16 were retrospectively collected. Histopathological findings in appendectomy specimens taken from patients who had a prediagnosis of appendicitis were obtained. Incidental appendectomies were not included in the research. Unusual findings were reevaluated in the histopathological assessment of appendectomy specimens. The number of patients whose pathological findings are considered unusual is 25 (1.91 %). Nine of the patients were girls and 16 of them were boys. Their ages ranged from 6 to 15. Pathological results revealed that there were 16 (1.22 %) cases of parasitosis, 3 (0.23 %) cases of granulomatosis, 3 (0.23 %) cases of eosinophilic appendicitis, 2 (0.15 %) cases of carcinoid tumors, and 1 (0.08 %) case of appendiceal non-Hodgkin's lymphoma. All patients underwent a standard appendectomy. Uncommon histopathological findings in childhood appendectomy specimens are more common than those in adulthood. This kind of certain unexpected lesions of the appendix may require advanced diagnostics, careful clinical care, follow-up for years, and a multidisciplinary approach. Therefore, histopathological examinations of appendectomy specimens must be performed routinely.
Collapse
Affiliation(s)
- Sevgi Buyukbese Sarsu
- Department of Pediatric Surgery, Gaziantep Children's Hospital, 27090 Gaziantep, Turkey ; Ataturk M. Adnan Inanici C., 1107 Nolu S. Buyukbese Apt. K:4 Daire:8, Sehitkamil, 27090 Gaziantep, Turkey
| | - Ramazan Ucak
- Department of Pathology, Gaziantep Children's Hospital, 27090 Gaziantep, Turkey
| | - Mehmet Akif Buyukbese
- Department of Internal Medicine, KSU School of Medicine, 46050 Kahramanmaraş, Turkey
| | | | - Hale Deniz
- Department of Pathology, Gaziantep Children's Hospital, 27090 Gaziantep, Turkey
| |
Collapse
|
25
|
Hegazi MA, Patel TA. Acute Amoebic Appendicitis: Case Reports and Review of Parasitic Appendicitis. J Pediatric Infect Dis Soc 2013; 2:80-2. [PMID: 26619448 DOI: 10.1093/jpids/pis082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 07/27/2012] [Indexed: 11/14/2022]
Abstract
Amoebic appendicitis is very rare, occurring in about 0.5% to 2% of acute appendicitis, and usually not reported in children. We report a case of confirmed acute amoebic appendicitis complicating amoebic colitis in a 7-year-old Pakistani boy living in southern Jeddah, Saudi Arabia, and briefly review the literature on parasitic appendicitis.
Collapse
Affiliation(s)
- Moustafa A Hegazi
- Department of Pediatrics, Mansoura University Children's Hospital, Mansoura, Egypt; Departments of Pediatrics and Al-Jedanni Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Tabarek A Patel
- Clinical Pathology, Ibn Sina College Hospital Al-Jedanni Hospital, Jeddah, Kingdom of Saudi Arabia
| |
Collapse
|
26
|
Do intestinal parasitic infestations in patients with clinically acute appendicitis increase the rate of negative laparotomy? Analysis of 3863 cases from Turkey. GASTROENTEROLOGY REVIEW 2013; 8:366-9. [PMID: 24868285 PMCID: PMC4027828 DOI: 10.5114/pg.2013.39919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/20/2013] [Accepted: 03/28/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Acute appendicitis is the most frequently observed disease requiring emergency surgery. The role of parasites in its pathogenesis has long been discussed. The signs of the parasitic infestations can mimic the signs of acute appendicitis. Therefore, it can cause a negative laparotomy. AIM To evaluate the parasitic infestations of the appendix vermiformis whether increas the rate of negative laparotomy. MATERIAL AND METHODS The histopathology results of a total of 3863 patients who underwent appendectomy with clinically acute appendicitis were evaluated retrospectively. All appendectomy materials in which parasites were observed were evaluated with respect to the nature of the parasites and the findings of inflammation. Cases in which parasite tissue fragments and/or eggs as well as findings of inflammation were histopathologically observed in the appendix lumen were diagnosed with parasitic appendicitis. RESULTS Evidence of parasites was observed in 19 (0.49%) of the evaluated appendectomy materials. In 9 (47.3%) of these specimens that had evidence for parasites, findings for acute appendicitis and localized peritonitis were identified. Findings of acute appendicitis had not been identified in the other ten (52.7%) of the specimens. Enterobius vermicularis was the most frequently identified parasite. CONCLUSIONS In parasitic acute appendicitis, appendectomy in itself is not sufficient for treatment. Pharmacological treatment should also be administered after surgery. Patients should be evaluated prior to surgery for parasites, and diagnosis of acute appendicitis should be considered more cautiously in order to avoid negative laparotomies.
Collapse
|
27
|
|
28
|
References. Parasitology 2012. [DOI: 10.1002/9781119968986.refs] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
29
|
Akbulut S, Tas M, Sogutcu N, Arikanoglu Z, Basbug M, Ulku A, Semur H, Yagmur Y. Unusual histopathological findings in appendectomy specimens: A retrospective analysis and literature review. World J Gastroenterol 2011; 17:1961-70. [PMID: 21528073 PMCID: PMC3082748 DOI: 10.3748/wjg.v17.i15.1961] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Revised: 12/23/2010] [Accepted: 12/30/2010] [Indexed: 02/06/2023] Open
Abstract
AIM: To document unusual findings in appendectomy specimens.
METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens.
RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed.
CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination.
Collapse
|
30
|
Ajmera RK, Simon GL. Appendicitis associated with Taenia species: cause or coincidental? Vector Borne Zoonotic Dis 2010; 10:321-2. [PMID: 19589062 DOI: 10.1089/vbz.2009.0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A 23-year-old woman from Ethiopia presented with acute abdominal pain. Exploratory laparotomy revealed appendicitis, pathology of which showed numerous eggs consistent with Taenia species. Although Taenia appendicitis is rare, it should be considered in the differential diagnosis of patients presenting with appendicitis from endemic parts of the world.
Collapse
Affiliation(s)
- Ravi K Ajmera
- Department of Medicine/Infectious Diseases, George Washington University School of Medicine, Washington, District of Columbia 20037, USA
| | | |
Collapse
|
31
|
Cateau E, Yacoub M, Tavilien C, Becq-Giraudon B, Rodier MH. Enterobius vermicularis in the kidney: an unusual location. J Med Microbiol 2010; 59:860-861. [DOI: 10.1099/jmm.0.019380-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A woman was admitted to hospital with abdominal pain. A large kidney stone was recovered and a nephrectomy was performed. Histology revealed the unusual presence of multiple Enterobius vermicularis ova. However, no other parasitic element was recovered on further investigations.
Collapse
Affiliation(s)
- Estelle Cateau
- Laboratoire de Parasitologie et Mycologie Médicale, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Mokrane Yacoub
- Laboratoire d'Anatomie et Cytologie Pathologiques, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Christian Tavilien
- Service de Chirurgie, Centre Hospitalier, 2 rue Henri Dunant, 86501 Montmorillon, France
| | - Bertrand Becq-Giraudon
- Service des Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| | - Marie-Hélène Rodier
- Laboratoire de Parasitologie et Mycologie Médicale, CHU de Poitiers, 2 rue de la Milétrie, 86021 Poitiers Cedex, France
| |
Collapse
|
32
|
Sodergren MH, Jethwa P, Wilkinson S, Kerwat R. Presenting features of Enterobius vermicularis in the vermiform appendix. Scand J Gastroenterol 2009; 44:457-61. [PMID: 19085426 DOI: 10.1080/00365520802624227] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Enterobius vermicularis (pinworm) infestation can present with symptoms resembling acute appendicitis, although current evidence suggests that it does not necessarily cause acute appendicitis. The purpose of this study was to characterize the clinical presentation of patients with pinworms in the vermiform appendix and to establish features suggestive of this condition. MATERIAL AND METHODS A retrospective analysis of all patients undergoing appendicectomy with appendicular pinworms between 1998 and 2003 was undertaken. Patients were compared against 54 controls with confirmed acute suppurative appendicitis from the same time period. Presenting features, vital signs and modified Alvarado scores were obtained from the patients' records. RESULTS Eighteen out of 1150 patients (1.5%) undergoing appendicectomy were proven to have pinworms (age range 8-37 years, 12 F, 6 M). Two of 18 appendices containing pinworms showed evidence of inflammation. Patients with pinworms had significantly lower white cell counts (WCCs) than the control group (median 8.9 versus 14.7, p=0.045), lower total Alvarado scores (median 5.5 versus 7, p=0.01) and were more likely to have had recurrent episodes of right iliac fossa (RIF) pain and previous hospital admissions (p<0.001). CONCLUSIONS E. vermicularis infestation of the appendix should be considered in the differential diagnosis of patients who present with recurrent RIF pain but do not have a significantly raised WCCs, or high Alvarado scores. These patients should be investigated with early fecal sampling and night-time application of cellophane tape, and they may benefit from empirical antiparasitic treatment.
Collapse
|
33
|
An unusual cause of right lower quadrant pain. J Pediatr Gastroenterol Nutr 2009; 48:395. [PMID: 19322051 DOI: 10.1097/mpg.0b013e31819f756a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
|
34
|
Whitley S, Sookur P, McLean A, Power N. The appendix on CT. Clin Radiol 2009; 64:190-9. [PMID: 19103350 DOI: 10.1016/j.crad.2008.06.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2008] [Revised: 06/13/2008] [Accepted: 06/22/2008] [Indexed: 01/07/2023]
Abstract
Appendicitis can be a difficult clinical diagnosis to make. A negative appendicectomy rate of 20% has traditionally been accepted as the consequences of appendiceal perforation can be grave. Cross-sectional imaging is increasingly being employed in the investigation of adults with suspected appendicitis. This review will demonstrate the appearance of the normal appendix on computed tomography (CT) and its appearance in a range of inflammatory and neoplastic processes including appendicitis, Crohn's disease, infections, and benign and malignant tumours.
Collapse
Affiliation(s)
- S Whitley
- Sunnybrook Health Sciences Center, Toronto, Ontario, Canada.
| | | | | | | |
Collapse
|
35
|
Efraimidou E, Gatopoulou A, Stamos C, Lirantzopoulos N, Kouklakis G. Enterobius Vermicularis infection of the appendix as a cause of acute appendicitis in a Greek adolescent: a case report. CASES JOURNAL 2008; 1:376. [PMID: 19061517 PMCID: PMC2614947 DOI: 10.1186/1757-1626-1-376] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 12/06/2008] [Indexed: 11/10/2022]
Abstract
Gastrointestinal infection due to Enterobius vermicularis occurs worldwide and is considered to be the most common helminth infection. The simple presence of E. vermicularis in the appendix usually produces symptoms of acute appendicitis. The association of this parasitic infestation with acute appendicitis varies from 0.2%-41.8% worldwide. We present a case of a 15 year old female with enterobiasis of appendix presented with clinical features of acute appendicitis. The appendix was surgically removed and the specimen was pathologically diagnosed to contain of E. vermicularis in non-inflamed and histologically normal appendix. Even if this condition is not uncommon in the Greek population, to the best of our knowledge this is the first report presented in the English literature.
Collapse
Affiliation(s)
- Eleni Efraimidou
- Endoscopy Unit, Democritus University of Thrace, Alexandroupolis, Greece.
| | | | | | | | | |
Collapse
|