Appendiceal ascariasis in children.
BACKGROUND
The propensity of Ascaris lumbricoides to wander leads to varied surgical complications in the abdomen. Wandering A lumbricoides may sometimes reach the vermiform appendix and its presence there may remain silent or incite pathology. Our aim was to study ascariadial appendicitis.


METHODS
Over a period of 3 years, we identified children who were found to have appendiceal ascariasis during surgery for different intestinal complications due to ascariasis. We studied the relationship between ascariasis and its lodgement inside the vermiform appendix in these patients. No preoperative diagnosis was made in this series.


RESULTS
We found 11 patients with appendiceal ascariasis. It was incidentally found that 8/11 (72.7%) patients had worms inside their vermiform appendix but not appendicitis, whereas the remaining three patients (27.2%) were found to have Ascaris-associated appendicitis. The characteristic finding in Ascaris-infested vermiform appendix was that the worm is positioned with its head at the base and its tail at the tip of the appendix.


CONCLUSIONS
Migration of A lumbrocoides inside the vermiform appendix is an incidental finding and tends to pursue a silent course in most patients. Only rarely does the presence of Ascaris inside the vermiform appendix cause appendicitis.
Wani
Imtiaz
I
Department of Surgery, SMHS Hospital, Srinagar, Kashmir, 190 009, India. imtazwami@gmail.com
Maqbool
Muddasir
M
Amin
Abid
A
Shah
Firdous
F
Keema
Arshad
A
Singh
Jang
J
Kitagawa
Maki
M
Nazir
Mir
M
D000818:Animals; D001064:Appendicitis / Q000175:diagnosis* / Q000469:parasitology / Q000601:surgery; D001065:Appendix / Q000469:parasitology* / Q000601:surgery; D001196:Ascariasis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017164:Ascaris lumbricoides / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007415:Intestinal Obstruction / Q000209:etiology / Q000469:parasitology / Q000601:surgery; D008297:Male; D012307:Risk Factors