Clinicopathological review of schistosomal appendicitis in south western Nigeria.

BACKGROUND

Gastrointestinal schistosomiasis may involve the appendix and there is no specific clinical picture associated with the same.

METHODS

The clinical records and histopathological slides of all patients diagnosed with schistosomal appendicitis between January 1989 and December 2006 in Ile-Ife, south west Nigeria, were reviewed.

RESULT: Of 956 patients who had appendectomy at the Obafemi Awolowo University Teaching Hospital within the study period, 22 (2.3%) had histopathological diagnosis of schistosomal appendicitis. Eighteen (81.8%) were male whilst 4 (18.2%) were female. Their ages ranged between 15 and 63 years with a mean of 28.2 (+/- 5.6) years. The mean duration of right lower quadrant abdominal pain was 4.2 years. Appendiceal and periappendiceal adhesions were noted intraoperatively in 17 (77.3%) and the appendix was adjudged grossly inflamed in 9 (40.9%) patients. Submucosal fibrosis and eosinophilia were the common histopathological findings aside from submucosal oviposition. All patients received antischistosomal drugs and one patient developed adhesive intestinal obstruction 9 months after surgery.

CONCLUSION

Schistosomal appendicitis may present acutely but diagnosis is only reliably made at histopathological examination. Adequate follow-up is however required to ascertain long-term outcome.