Histopathological analysis of schistosomal appendicitis in Kano North-Western Nigeria

Abstract

Background: Schistosomiasis is a chronic granulomatous inflammation affecting many organs and systems of the body including the gastrointestinal tract with frequent involvement of the appendix. It presents with clinical diagnostic challenge without biopsy and histopathologic evaluation. The study aims to documents the histopathologic pattern of the appendiceal schistosomiasis in our environment. Material and Methods: A 15-year (2004 to 2018) review of all appendix specimens received in the department of Histopahology, Aminu Kano University Teaching Hospital. Information on age, sex and duration of disease was retrieved from request cards and patient case notes. Cases with histological evidence of Schistosomiasis were selected for the study. Data presented as frequency distribution tables, charts and photomicrographs. Results: Thirty six (36) cases of histopathologically confirmed Schistosomal appendicitis constituting 3.2% of all appendectomy specimen with male to female ratio of 9:1, and peak incidence in the third decade of life. Majority (83.3%) of cases show granuloma formation with either calcified or viable schistosoma ova or both. Only 6 cases show Minimal inflammatory response and calcified schistosoma ova. The most common presentation was recurrent and acute appendicitis. Conclusion: Appendiceal schistosomiasis constitutes 3.2% of appendiceal lesions in our settings, affecting predominantly young male. High index of suspicions is therefore advocated in all cases of acute recurrent abdominal pains to avoid unnecessary surgical trauma.