Schistosomiasis Presenting as a Case of Acute Appendicitis with Chronic Mesenteric Thrombosis

Mosli, Mohammed H.; Chan, Wilson; Morava-Protzner, Izabella; Kuhn, Susan

doi:10.1155/2016/5863219

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…However, in patients with schistosomal appendicitis, it is unclear whether schistosomiasis of the appendix induces acute inflammation. According to previous reports, any of the three schistosoma species can cause acute appendicitis [6, 10, 11]. However, we recognized the schistosome eggs in our patient as belonging to S. japonicum morphologically, so S. japonicum was deemed to be the cause of acute appendicitis.…”

Section: Discussionmentioning

confidence: 59%

Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report

et al. 2019

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Background Schistosomiasis is prevalent in tropical and subtropical areas and rarely reported in developed countries. Schistosomiasis often occurs as a chronic illness, which can cause liver and intestinal damage. Appendicitis is an unusual complication of schistosomiasis. We herein present a case of acute appendicitis associated with the presence of schistosome eggs in a sailor from the Philippines. Case presentation A 34-year-old Filipino man who worked as a sailor presented to our hospital with a 2-day history of acute right lower quadrant abdominal pain and fever. A physical examination revealed right lower quadrant abdominal pain with signs of peritoneal irritation, including rebound tenderness. Computed tomography revealed thickening of the appendix associated with mural calcification and fluid collection around the cecum. Based on these findings, the preoperative diagnosis was acute appendicitis. Laparoscopic appendectomy was performed. Swelling of the appendix and contaminated ascites were observed intraoperatively, but there was no evidence of appendiceal perforation. A histopathological examination showed inflammation of the appendix wall and numerous ovoid bodies present within the submucosa, many of which were calcified. Severe infiltration of lymphocytes and fibrosis were recognized around the oval bodies. The numerous oval bodies were morphologically consistent with schistosomiasis. The final diagnosis was acute phlegmonous appendicitis associated with the presence of schistosome eggs. We examined the patient for signs of adult worm activity, but the results of stool ova and parasite examinations performed twice were negative. He was discharged and returned to his country on postoperative day 9. Conclusions The incidence of schistosomal appendicitis, which is seldom reported in developed countries, is expected to increase in Japan in the near future. Clinicians should suspect schistosome eggs as a cause of acute appendicitis in patients who have emigrated from or are traveling from endemic areas, and when mural calcification of the appendix is observed on imaging.

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Section: Discussionmentioning

confidence: 59%

Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report

et al. 2019

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“…5 Although rare, ectopic schistosomiasis has been reported in the heart, ovaries, uterus, fallopian tubes, ureters, urinary bladder, and the appendix. 6 The preferred anatomic location for residence and egg deposition varies by species. S. japonicum in particular often resides in the inferior and superior mesenteric veins.…”

Section: Discussionmentioning

confidence: 99%

“…Several ectopic localizations for various species of Schistosoma have been documented before. 6,7 The first-ever known case of appendiceal schistosomiasis was reported by Turner in 1909 and has been described in many reports, especially in endemic areas but to our knowledge, there is only one other reported case that progressed to ruptured appendicitis and subsequent At the emergency room, a physical examination of the abdomen revealed tenderness on all quadrants upon light palpation, with note of muscular guarding. Vital signs remained normal and the patient was afebrile.…”

Section: Introductionmentioning

confidence: 98%

Ectopic Schistosomiasis Presenting as Ruptured Appendicitis with Periappendiceal Abscess Formation

Fierro¹,

Tan²,

Torno³

2022

Phil Journal Path

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Schistosomiasis is still a public health burden in the Philippines. Chronic infection with Schistosoma japonicum, the only species endemic in the Philippines, clinically manifests itself in a wide variety of pathologies usually correlated with the anatomical site of adult worm activity and deposition of eggs. One of the documented ectopic sites for Schistosoma ova is the appendix. A rare sequela of this is acute appendicitis and an even rarer consequence is progression to appendiceal rupture leading to acute peritonitis. We present a case of a 27-year-old Filipino residing in Davao City but born in Agusan Province who initially complained of right lower quadrant abdominal pain but presented at the emergency room with generalized abdominal tenderness with signs of peritoneal irritation. Exploratory laparotomy with an infraumbilical incision revealed ruptured appendicitis with periappendiceal abscess formation and appendectomy was subsequently done. Schistosoma infection of the appendix was subsequently established by histopathological analysis. Furthermore, features observed suggest an atypical pathogenetic process contrary to the putative pathogenesis of most cases of acute appendicitis.

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“…Acute patients present with immune complex disease, while chronic patients present with T lymphocyte-mediated delayed allergies, which may be accompanied by the deposition of antigen-antibody complexes to form eosinophilic granuloma. With the degeneration, necrosis, and calcification of worm eggs, infiltrating cells were replaced by monocytes and fibroblasts to form chronic granulomas [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Intestinal schistosomiasis masquerading as intestinal polyps

Zhu

Song

et al. 2021

BMC Infect Dis

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Background Schistosomiasis is very common in the southern part of the Yangtze River Basin in China. It is mainly manifested as appendicitis, ulcers, hematomas, and thickening of the intestinal tract. Schistosomiasis of the appendix is rare, mainly manifested as appendicitis, which is easy to be misdiagnosed. Case presentation Here we report a rare case of a Chinese female whose intestinal mass manifested as intestinal polyps and was eventually diagnosed pathologically as schistosomiasis infection (appendix schistosomiasis). So far, there are rare relevant cases reported. Conclusions Intestinal schistosomiasis is easily misdiagnosed, and appendix schistosomiasis is rare. The final diagnosis requires pathology, especially surgical pathology.

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Schistosomiasis Presenting as a Case of Acute Appendicitis with Chronic Mesenteric Thrombosis

Cited by 7 publications

References 7 publications

Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report

Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report

Ectopic Schistosomiasis Presenting as Ruptured Appendicitis with Periappendiceal Abscess Formation

Intestinal schistosomiasis masquerading as intestinal polyps

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