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Scholars Journal of Applied Medical Sciences | Volume-3 | Issue-01
The Rare Association of Enterobius vermicularis Infestation Causing Acute Appendicitis in Children: A Case Report and Review of the Literature
Sheikh Hasan Habib, Waliza Ansar, Shyamasree Ghosh, and Achintya Kumar Das
Published: March 26, 2015 |
203
183
DOI: 10.36347/sjams.2015.v03i01.010
Pages: 38-44
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Abstract
Acute appendicitis is the commonest causes of emergency surgery, having worldwide prevalence and affects
all age groups. The etiology of acute appendicitis is multi-factorial and the pathology is most likely the obstruction of the
lumen of the appendix. Acute appendicitis due to helminthes and protozoan infection is quite rare. Other unusual findings
in appendectomy specimens are benign or malignant tumors. The presence of parasitic helminth Enterobius vermicularis
(pinworm) in the appendix sometimes produces symptoms of acute appendicitis without any histological evidence, even
though a patient might not have appendicitis. The causal relationship of appendicitis and pin worms’ remains
controversial. We present here a case of an 11-year old boy with enterobiasis of appendix presented with clinical features
of acute appendicitis. E. vermicularis was discovered inadvertently after laproscopic appendectomy in a highly inflamed
appendix. Prior to surgery, no parasites were revealed histopathologically. The relevant literature is also reviewed as
accessed via PubMed and Google Scholar databases. Pinworm infestation can have various clinical presentations,
including non-specific symptoms of decreased appetite, peri-anal pruritis, and loss of sleep. In acute condition, it can
produce symptoms of 'appendiceal colic', or acute appendicitis in a non-inflamed appendix; or induce chronic
inflammatory eosinophilic infiltrate or no tissue reaction in a histological appendicitis. In conclusion, the most common
surgical condition in children is acute appendicitis. Parasitic infestations are a concern on a worldwide basis. The role of
parasitic infestation in relation to appendicitis is controversial. Intestinal parasites may cause noteworthy morbidity and
mortality.