Oxyuris granulomas of pelvic peritoneum and appendicular wall

Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient

We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing.

'Wormy'form appendix

Appendicitis and helminth infections are both common conditions in children. However, helminths (pinworms) infestation causing appendiceal luminal obstruction and presenting as appendicitis is uncommon.

Enterobiasis in ectopic locations mimicking tumor-like lesions

Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.”

Laparoscopic appendectomy in children with Enterobius vermicularis

As surgeons gain more experience with laparoscopy in children, it is becoming apparent that one of the best applications of the technique is for appendicitis. The advantages of laparoscopic appendectomy include a better cosmetic result, particularly in young female patients, a shorter recovery time, and an early return to normal activities. In the differential diagnosis of appendicitis, the association of Enterobius vermicularis (pinworms) inflammation in the pediatric age group is not uncommon. The endo-loop technique for laparoscopic appendectomy is the standard technique used in our department. In three patients with E. vermicularis undergoing appendix removal using this technique, pinworms were found to be set free into the abdomen after dividing the appendix between the loop ligatures. Bipolar coagulating forceps were used carefully to thermally desiccate the worms, which were then removed using a blunt grasper. E. vermicularis being released into the abdomen in children undergoing laparoscopic appendectomy using the endo-loop technique has not been reported. Careful evaluation of the appendix stump and simple but careful thermal desiccation and removal of pinworms, if present, must be considered when using the endo-loop technique.

Intraperitoneal Enterobius vermicularis infection: a case report

BACKGROUND

Enterobius vermicularis in an ectopic location usually represents an incidental finding in tissue specimens in a patient without symptoms. However, the parasite can lead to inflammation and symptoms in rare cases.

CASE

A 36-year-old woman had an abdominal hysterectomy for menorrhagia, dyspareunia, and lower abdominal pain. Two small nodules from the posterior aspect of the left broad ligament as well as the uterus were sent for histologic examination. The pathologic findings confirmed the diagnosis of "granulomatous peritoneal nodules due to E. vermicularis." Within the nodules were aggregates of ova of E. vermicularis.

CONCLUSION

This case reminds us that such granulomatous lesions can simulate leiomyoma, fibroma, endometrioma, and tuberculous or malignant lesions. It is important to be aware of this resemblance to avoid unnecessary surgical intervention.

Pathology of tropical appendicitis

Over the past 25 years, 2921 appendicectomies were performed at this hospital. All were subjected to routine histopathological examination. In 95% of cases, histopathological examination did not add any further information but in 153 (5%) cases, clinically important pathological findings were detected for the first time. Seventy (2.3%) specimens showed typical evidence of tuberculosis. Parasitic infestation was detected in 75 (2.5%), including enterobiasis (1.4%), amoebiasis (0.5%), ascariasis (0.5%), ascariasis with trichuriasis (0.05%), and taeniasis (0.05%). Other lesions found were mucocele (0.1%) and carcinoid tumour (0.1%). It is concluded that routine histopathological examination of all appendicectomy specimens should be performed to avoid missing any clinically important and treatable condition.

Value of routine histopathological examination of appendices in Hong Kong

A retrospective study of the histopathological findings of more than 11,443 appendices submitted as surgical specimens over 14 years was performed in this department. In most cases routine histopathological examination added little clinically important information to other clinical and operative gross findings, but a variety of interesting and uncommon lesions were identified. In 85 cases clinically important pathological findings were first discovered on routine histopathological examination. These included enterobiasis, schistosomiasis, mucocele, trichuriasis, tuberculosis, ascariasis, endometriosis, mucinous cystadenoma, granuloma, carcinoid tumour, neuroma, clonorchiasis, primary adenocarcinoma and secondary carcinoma.

Enterobius (Oxyuris) vermicularis of the pelvic peritoneum--a cause of infertility

A case of Enterobius (Oxyuris) vermicularis granulomatous disease of the pelvic peritoneum causing pelvic adhesions and infertility is presented and discussed. Since parasitic diseases are common in the developing countries, the infertility team has to bear in mind that a parasitic disease might be the main cause of infertility.

Bilateral enterobius vermicularis salpingo-oophoritis

Inflammatory pelvic disease secondary to infection with Enterobius vermicularis is rare in that pinworms are usually asymptomatic inhabitants of the terminal small bowel and cecum. When these parasites do cause symptoms, however, there is a spectrum of gastrointestinal and genitourinary complaints. A case is presented of a woman with bilateral abdominal pain that was found to be due to a combination of parasitic and bacterial (Bacteroides fragilis) infection. The parasitic fallopian tube infection may have predisposed the fallopian tubes to a microbial tuboovarian abscess.