Ectopic Schistosomiasis Presenting as Ruptured Appendicitis with Periappendiceal Abscess Formation

An Alternative Pathogenetic Perspective

  • Marcel Joshua Del Fierro Metro Davao Medical and Research Center, Inc., Davao City, Philippines https://orcid.org/0000-0001-6530-4302
  • Yvette Tan Metro Davao Medical and Research Center, Inc., Davao City, Philippines
  • Larissa Lara Torno Metro Davao Medical and Research Center, Inc., Davao City, Philippines
Keywords: schistosomiasis, Schistosoma japonicum, acute appendicitis, periappendiceal abscess

Abstract

Schistosomiasis is still a public health burden in the Philippines. Chronic infection with Schistosoma japonicum, the only species endemic in the Philippines, clinically manifests itself in a wide variety of pathologies usually correlated with the anatomical site of adult worm activity and deposition of eggs. One of the documented ectopic sites for Schistosoma ova is the appendix. A rare sequela of this is acute appendicitis and an even rarer consequence is progression to appendiceal rupture leading to acute peritonitis. We present a case of a 27-year-old Filipino residing in Davao City but born in Agusan Province who initially complained of right lower quadrant abdominal pain but presented at the emergency room with generalized abdominal tenderness with signs of peritoneal irritation. Exploratory laparotomy with an infraumbilical incision revealed ruptured appendicitis with periappendiceal abscess formation and appendectomy was subsequently done. Schistosoma infection of the appendix was subsequently established by histopathological analysis. Furthermore, features observed suggest an atypical pathogenetic process contrary to the putative pathogenesis of most cases of acute appendicitis.

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Author Biographies

Marcel Joshua Del Fierro, Metro Davao Medical and Research Center, Inc., Davao City, Philippines

Department of Internal Medicine

Yvette Tan, Metro Davao Medical and Research Center, Inc., Davao City, Philippines

Department of Internal Medicine

Larissa Lara Torno, Metro Davao Medical and Research Center, Inc., Davao City, Philippines

Department of Internal Medicine

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Published
2022-06-10
How to Cite
Del Fierro, M. J., Tan, Y., & Torno, L. L. (2022). Ectopic Schistosomiasis Presenting as Ruptured Appendicitis with Periappendiceal Abscess Formation : An Alternative Pathogenetic Perspective. PJP, 7(1), 53-56. https://doi.org/10.21141/PJP.2022.07