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Incidental parasitic infestations in surgically removed appendices: a retrospective analysis.

Aydin O - Diagn Pathol (2007)

Bottom Line: Of the 190 appendectomies performed, 6 specimens (3,15%) were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies).In 3 of 4 bland appendices, results favored acute appendicitis.The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Alanya Hospital, Baskent University, Antalya, Turkey. darkeetar@yahoo.com

ABSTRACT

Background: Appendiceal parasites can cause symptoms of appendiceal pain, independent of microscopic evidence of acute inflammation. The diagnosis of a parasitic infestation is generally achieved only after the pathologic examination of the resected appendices.

Patients/methods: Pathology department records were reviewed for all patients who required an operation for symptoms of acute appendicitis between 2000 and 2006. The specimens which were pathologically diagnosed to contain parasites were reevaluated for features of acute inflammation, and parasite type. The medical records were reviewed in detail to achieve a diagnostic score(Eskelinen). Radiologic imaging findings were correlated, if present.

Results: Of the 190 appendectomies performed, 6 specimens (3,15%) were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies). Appendectomies with Taenia showed acute inflammation, while acute inflammation was absent in the ones with Enterobius vermicularis. The Eskelinen score was higher than the threshold in two cases with an acute inflammation, and in two without. Ultrasound scans, and a computed tomography scan were performed in 5 patients. In 3 of 4 bland appendices, results favored acute appendicitis.

Conclusion: The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens. Timely diagnosis and appropriate therapy might prevent probable future complications that may necessitate surgical procedures, at least in some of the patients. The clinical management of these infections is different from that for classical appendicitis.

No MeSH data available.


Related in: MedlinePlus

the fragment of helminthe was seen in the lumina as an elongated and flattened segment with eggs(original magnification × 40).
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Figure 1: the fragment of helminthe was seen in the lumina as an elongated and flattened segment with eggs(original magnification × 40).

Mentions: In 4 of cases, the parasites were identified as Enterobius vermicularis(E. vermicularis); and in 2 as Taenia subspecies(Taenia spp.). In cases with Taenia, appendices showed the macroscopic and microscopic features of acute appendicitis. A formalin fixed segment of the parasite had been observed, but not recognised by the technician who had handled the specimen. Microscopic slides presented mucosal ulceration, and luminal exudate accompanied by an elongated and flattened segment of the helminthe. A large number of round eggs with a thick radially striated shell were within the parasites uterus and were also freely floating in the lumina(Fig. 1). The characteristics allowed to conclude that the helminthe belonged to the genus Taenia. In cases with E. vermicularis, macroscopic examination showed bright and swollen appendices with serosal congestion. Histopathology revealed the lack of acute inflamation, only after many serial sections. Appendices contained luminal vegetable material and many transverse or vertical transected pinworms with a chronic inflammatory infiltrate predominated by eosinophils(Fig 2).


Incidental parasitic infestations in surgically removed appendices: a retrospective analysis.

Aydin O - Diagn Pathol (2007)

the fragment of helminthe was seen in the lumina as an elongated and flattened segment with eggs(original magnification × 40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1887519&req=5

Figure 1: the fragment of helminthe was seen in the lumina as an elongated and flattened segment with eggs(original magnification × 40).
Mentions: In 4 of cases, the parasites were identified as Enterobius vermicularis(E. vermicularis); and in 2 as Taenia subspecies(Taenia spp.). In cases with Taenia, appendices showed the macroscopic and microscopic features of acute appendicitis. A formalin fixed segment of the parasite had been observed, but not recognised by the technician who had handled the specimen. Microscopic slides presented mucosal ulceration, and luminal exudate accompanied by an elongated and flattened segment of the helminthe. A large number of round eggs with a thick radially striated shell were within the parasites uterus and were also freely floating in the lumina(Fig. 1). The characteristics allowed to conclude that the helminthe belonged to the genus Taenia. In cases with E. vermicularis, macroscopic examination showed bright and swollen appendices with serosal congestion. Histopathology revealed the lack of acute inflamation, only after many serial sections. Appendices contained luminal vegetable material and many transverse or vertical transected pinworms with a chronic inflammatory infiltrate predominated by eosinophils(Fig 2).

Bottom Line: Of the 190 appendectomies performed, 6 specimens (3,15%) were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies).In 3 of 4 bland appendices, results favored acute appendicitis.The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Alanya Hospital, Baskent University, Antalya, Turkey. darkeetar@yahoo.com

ABSTRACT

Background: Appendiceal parasites can cause symptoms of appendiceal pain, independent of microscopic evidence of acute inflammation. The diagnosis of a parasitic infestation is generally achieved only after the pathologic examination of the resected appendices.

Patients/methods: Pathology department records were reviewed for all patients who required an operation for symptoms of acute appendicitis between 2000 and 2006. The specimens which were pathologically diagnosed to contain parasites were reevaluated for features of acute inflammation, and parasite type. The medical records were reviewed in detail to achieve a diagnostic score(Eskelinen). Radiologic imaging findings were correlated, if present.

Results: Of the 190 appendectomies performed, 6 specimens (3,15%) were found to contain parasites(4 Enterobius vermicularis, 2 Taenia subspecies). Appendectomies with Taenia showed acute inflammation, while acute inflammation was absent in the ones with Enterobius vermicularis. The Eskelinen score was higher than the threshold in two cases with an acute inflammation, and in two without. Ultrasound scans, and a computed tomography scan were performed in 5 patients. In 3 of 4 bland appendices, results favored acute appendicitis.

Conclusion: The diagnosis of gastrointestinal parasites is not only made by examining the stool but the diagnosis can be made by histology from surgical specimens. Timely diagnosis and appropriate therapy might prevent probable future complications that may necessitate surgical procedures, at least in some of the patients. The clinical management of these infections is different from that for classical appendicitis.

No MeSH data available.


Related in: MedlinePlus