Pathological changes in appendectomy specimens including the role of parasites: A retrospective study of 2400 cases of acute appendicitis

Background: Parasitic infestation of the appendix is uncommon. Parasitic infections can cause inflammation in the appendix and can imitate acute appendicitis clinically. Enterobius vermicularis and Taenia species are among the most common parasitic agents causing acute appendicitis. Objective: We have studied the ratio of parasites causing acute appendicitis in appendectomy specimens and whether there is any relationship between the type of the parasite, histopathological type of acute appendicitis, age of the patient, and gender of the patient in the appendectomy cases. Materials and Methods: We retrospectively analyzed the data of 2400 patients who underwent appendectomy with the prediagnosis of acute appendicitis between 1 st January 2004 and 31 st March 2018 at Erzincan University. The age of the patient, gender of the patient, histopathologic type of acute appendicitis, and the type of parasite were retrospectively analyzed. Positive appendectomy specimens for histopathological features of acute appendicitis were classified into four groups: Catarrhal appendicitis, suppurative appendicitis, gangrenous appendicitis, and perforated appendicitis. Results: In all, 1451 were males and 949 were females. The mean age was 25.51 years. No acute inflammation was found in 36 appendectomy specimens. The distribution of 2364 cases involving acute appendicitis was as follows: Catarrhal appendicitis: 438, suppurative appendicitis: 300, gangrenous appendicitis: 1082, and perforated appendicitis: 544. Parasites were identified in 32 cases. The ratio of appendices to parasites was 1.3%. The number of appendectomy cases with Enterobius vermicularis was 22, and the number with Taenia species was 10. Conclusion: Although they are a rare cause of acute appendicitis, parasitic infestations must always be considered. Accurate identification of acute appendicitis and appropriate therapy will improve the quality of life as much as the prevention of acute appendicitis sourced from parasites. © 2019 Nigerian Journal of Clinical Practice.