Acute appendicitis associated with the presence of schistosome eggs in a sailor: a case report
| Autor: | Keiji Inoue, Masataka Hirabaru, Shigeki Minami, Hajime Imamura, Michi Morita, Junji Irie, Susumu Eguchi, Masashi Haraguchi, Kazumasa Noda, Hirotaka Tokai, Yuriko Isagawa, Daisuke Kawahara |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Abdominal pain lcsh:Surgery Schistosomiasis Physical examination Case Report Appendix Gastroenterology 03 medical and health sciences Cecum 0302 clinical medicine Internal medicine Ascites medicine medicine.diagnostic_test business.industry Mural calcification lcsh:RD1-811 medicine.disease Appendicitis medicine.anatomical_structure Schistosomal appendicitis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology medicine.symptom Complication business |
| Zdroj: | Surgical Case Reports Surgical Case Reports, Vol 5, Iss 1, Pp 1-4 (2019) |
| ISSN: | 2198-7793 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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