Clinico-pathological profile of schistosomal appendicitis detected in surgically resected appendices: A retrospective study

Background

Appendicular schistosomiasis (AS) is an uncommon cause of acute appendicitis that can only be diagnosed histopathologically. There are few reports of AS and its histopathological profile is unclear in Egypt. Therefore, we aimed to evaluate the prevalence and clinicopathological, profile of AS among patients presented with acute appendicitis for proper management and to reduce the health burden of the disease.

Methods

This is a retrospective study performed at a university hospital comprising all patients with pathological confirmation of appendiceal Schistosomiasis after appendectomies between 2017 and 2021. All data were extracted from patient's files including age, sex, residence, main patient's complaint, Alvarado scores, and laboratory data. The histopathological specimens were reviewed by the histopathologist in this study and special stains were done when indicated.

Results

The prevalence of AS was 1.07% (20/1870), all of them were adults or old age with a mean age of 39.25, 80% of cases were males. The most frequent clinical presentation in our patients was abdominal pain in the right iliac fossa (96%) with a mean duration of symptoms of 2.5 days. At the time of the operation, two patients had perforations, with no recorded mortality. Only 20% showed gross unusual foci, and lymphoplasmacytic infiltration was seen in 90% of cases. All patients were advised to postoperative praziquantel therapy.

Conclusion

Histopathological evaluation for schistosomiasis in all surgically removed appendix is recommended in endemic areas for middle and old ages and comprehensive postoperative follow-up with praziquantel therapy is required to ensure disease eradication and prevent further complications.