Enterobius vermicularis and clinical appendicitis: worms in the vermiform appendix

An ‘appendiceal colic’ caused by theEnterobius vermicularis

“…This is of a particular importance to surgeons as free intraperitoneal contamination may have serious consequences including omentitis, pelvic peritoneal granuloma, salpingitis, chronic pelvic pain and pelvic inflammatory disease 2 4. In addition, if untreated colitis and perianal abscess have been described 2…”

“…The histopathological appearances associated with the E vermicularis infestation may vary from lymphoid hyperplasia, chronic inflammatory infiltrate of eosinophils, acute phlegmonous appendicitis and even gangrenous appendicitis with perforation 2 4 6. Whereas, in the absence of histological evidence of an inflammation, but with clinical features suggesting an acute appendicitis, some authors use the term of ‘appendiceal colic’ 2.…”

“…Second, a staged division of the appendix should be undertaken with inspection of the appendiceal lumen 2 4. If worms are visible, then direct retrieval with endoscopic suction or a grasper is indicated 4.…”

“…If worms are visible, then direct retrieval with endoscopic suction or a grasper is indicated 4. Additionally, thermal desiccation using endoscopic scissors with supplementary diathermy directly onto the pinworms while still attached to the mucosa of the appendiceal stump may be helpful 2.…”

“…Additionally, thermal desiccation using endoscopic scissors with supplementary diathermy directly onto the pinworms while still attached to the mucosa of the appendiceal stump may be helpful 2. Finally, careful inspection of the port site through which the appendix is delivered is required to avoid contamination 4. In the event of spillage, meticulous inspection and endoscopic suction are recommended 4…”