Schistosomal appendicitis in the Eastern Province of Saudi Arabia: A clinicopathological study.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Meshikhes
A W
AW
Departments of Surgery and Pathology, Dammam Central Hospital, Dammam, Eastern Province, Saudi Arabia.
Chandrashekar
C J
CJ
Al-Daolah
Q
Q
Al-Saif
O
O
Al-Joaib
A S
AS
Al-Habib
S S
SS
Gomaa
R A
RA