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Schistosomiasis: an
unusual cause of right lower quadrant abdominal pain.J
Natl Med Assoc. 1997 Jul;89(7):461-3.
Schistosomiasis,
although unusual in North America, is a common disease worldwide.
Symptoms vary depending on the species involved. Immigrants from
endemic regions are the commonly affected patients found in North
America. In most cases, schistosomiasis does not present with right
lower quadrant pain. Even in endemic regions, this form of
presentation is uncommon. In the United States, most cases of right
lower quadrant pain often will be treated as appendicitis. Questions
remain unanswered as to whether the schistosomes cause appendicitis
or are found incidentally in these cases. Stool and urine specimens
may be helpful in making a diagnosis. Most cases require operative
intervention to rule out appendicitis and to obtain tissue for
histopathologic diagnosis. Praziquantel is effective in eradicating
infestations.
Schistosomal
appendicitis.
Ann Saudi Med. 1995 Jul;15(4):347-9.
This is a
retrospective study involving 4708 consecutive appendix specimens
removed over a period of 6.5 years for a clinical diagnosis of acute
appendicitis, 64 (1.3%) of which showed histological evidence of
schistosomiasis. Thirty-four schistosomal appendicitis (SA) cases
were compared with 68 non-schistosomal appendicitis (NSA) cases
admitted during the same period. SA patients were older in age,
usually of male sex, mostly Egyptians and tended to have a higher
hemoglobin and a lower leukocyte count (P<0.05). Other features were
not significantly different. It is concluded that, despite these
differences, there are no reliable clinical or laboratory features
by which SA can be predicted preoperatively. The majority of the
studied patients were either discharged before the results of the
histopathology study were ready and were lost to follow-up or the
reports were overlooked. Therefore, we recommend that for all
post-appendectomy patients living in or coming from endemic areas of
schistosomiasis, the results of the histopathology study should be
processed as early as possible and before the patient can be
discharged so that the treatment can be commenced. Moreover,
establishing a system by which infected patients could be traced and
hence treated is highly recommended. |