Parasitic Infections of the Appendix as a Cause of Appendectomy in Adult Patients

Abstract

Objective: Assessment of frequency and clinical findings of parasitic infections for etiology of acute appendicitis. Methods: Data of 1452 patients who were carried out appendectomy between January 1999 and December 2012 were analyzed retrospectively. Appendectomy was performed in 1159 of the patients with a pre diagnosis of acute appendicitis. Demographics, physical findings, radiologic and laboratory studies, operative findings, pathological results, presence and type of parasitosis were investigated. Results: Among the 1159 patients done appendectomy with a pre diagnosis of acute appendicitis, 719 (62%) were males and 440 (38%) were females. Parasitic infection was demonstrated in 17 (1.4%) of them. Mean average age of these patients was 36.6±20.1 years. Enterobius vermicularis was present in 15 (88.2%) and Entamoeba histolytica in 2 (11.8%) of the patients. Of the pathology specimens of appendix consisting Enterobius vermicularis, 12 (80%) were normal appendix tissues, 1 (6.6%) was acute uncomplicated appendicitis and 2 (13.3%) were perforated appendicitis. One (50%) of the two specimens consisting Entamoeba histolytica was normal appendix and the other (50%) was acute appendicitis. Conclusion: Differential diagnosis of parasitic infections in etiology of acute appendicitis should be made properly. It must be remembered that this attention can save patients from a negative laparotomy and morbidity and mortality of it. (Turkiye Parazitol Derg 2014; 38: 12-6) (Turkiye Parazitol Derg 2014; 38: 12-6)

Parasitic infestation in appendicitis. A retrospective analysis of 660 patients and brief literature review

“…Appendicitis is the most common cause of abdominal pain and one of the most common reasons for emergency gastrointestinal surgery 1-4. Appendicitis, which is generally seen in patients aged 10-30 years, is the most common cause of emergency abdominal surgery in children 5.…”

“…Fecal stasis, fecaliths and lymphoid hyperplasia often take place in the etiology of appendicitis. Intestinal parasites, tumors, radiological studies in which barium is used, undigested vegetable residues and fruit seeds are also rarely identified in appendicitis etiology 4. Gastrointestinal system infections due to parasitic and protozoal infestations have various incidences throughout the world 2,4.…”

“…Studies involving large series of cases which have investigated the incidence of parasites in appendectomy specimens were reviewed, and this rate was determined to be 1.2%. Parasites have been reported to cause appendicitis by obstructing the lumen both without any acute inflammation and by creating an inflammatory reaction 4,7. However, the role of parasites in the pathogenesis of appendicitis has not been clearly identified yet 4,7.…”

Amoebic chronic appendicitis: a rare entity

“…The literature contains only a few reports of amebic appendicitis. [3][4][5] Exact incidence of this unusual presentation of parasitic disease is not well known. Before operation, routine laboratory tests are generally not useful but leukocytosis and anaemia may be seen and can be correlate.…”

Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

“…Although the exact pathogenic cause of appendicitis is still unclear, internal obstruction (e.g., by a fecalith, lymphoid hyperplasia, or tumor) and direct invasion of microorganisms are some of the suggested etiologies of appendicitis (2). Although the majority of causative microorganisms are bacteria, cases of appendicitis caused by Entamoeba histolytica (amoebic appendicitis) have been reported (3, 4). …”