Acute appendicitis may be the first manifestation of schistosomiasis

Objective: To investigate whether schistosomiasis can cause and present with clinical and pathological acute appendicitis as the mode of first presentation. Design: Retrospective study of clinical, laboratory, and histopathology findings in 757 patients who underwent appendicectomy between May 1996 and May 1997 in Al Ain Hospital, UAE. Settings: Male and Female surgical wards in Al Ain Hospital, UAE. Subjects: Seven hundred and fifty seven patients who underwent appendicectomy between May 1996 and May 1997, presented with abdominal pain and were suspected to have acute appendicitis. Main Outcome Measure: Schistosomal appendicitis observed in 0.08% of 757 operations. Results: Appendicitis was confirmed in 675 patients (89.2%), of whom 80.6% were males, and 19.5% were females. Patients affected with schistosomiasis were from endemic areas and in the second and third decades of life. All had abdominal pain and rebound tenderness in the right iliac fossa. Conclusion: Acute schistosomal appendicitis may be the first presentation of the disease among patients coming from endemic areas. Ova deposition in appendicular wall with subsequent luminal obstruction leads to unexplained recurrent abdominal pain. Patients with Schistosomal appendicitis should receive chemotherapy to eradicate schistosomal trematodes.