Schistosomal appendicitis in the eastern province of Saudi Arabia: a clinicopathological study

ABSTRACT

In cases of schistosomiasis, the appendix is commonly infested. It is not known if this is a predisposing factor for appendicitis, or a mere coincidental histological finding. Patients and A total of 56 patients [51 males and 5 females] underwent appendectomy for schistosomal appendicitis over a 10-year period at Dammam Central Hospital. The histological slides of 41 of the patients [73.2%] were retrospectively studied. The highest incidence of schistosomal appendicitis was recorded in the 21-40-year age group. Ova were seen in the submucosal layers of all the excised appendices. The most common tissue responses were submucosal fibrosis [92.7%] and eosinophilia [87.8%], followed by the presence of suppurative inflammation [80.5%]. Granulomatous reaction was evident in only 13 cases [31.7%]. A striking feature was atrophy of submucosal lymphoid follicles in 70.7% of the cases. Hyperplasia of lymphoid follicles and serosal granulomas were rare [2.4%]. Similar tissue responses were histologically seen in four normal appendices examined. Appendiceal infestation may predispose to appendicitis in the majority of affected cases, but in others, it may well be a mere coincidental histological finding. However, preoperative knowledge bears no clinical significance and does not alter management