Enterobius Vermicularis Unusual Cause of Appendicitis: A Case Report
Authors: Shahraki Ahmad Reza , Shahraki Elham , Shahraki Elahe 
Published: August 2024

Abdominal pain is common in children (under 18 years) with a strong female preponderance in those aged over 8 years. Of those presenting with acute abdominal pain requiring inpatient assessment, only 25% have acute appendicitis. Pinworms are the most common helminth infection in the USA and Western Europe, with prevalence rates in some communities of as high as 30-50%. Pinworms generally live in the gastrointestinal tract, and helminth infestations have been noted in over one-quarter of acute appendectomies on histologic examination. Acute appendicitis is one of the most common emergent surgeries. Generally, appendicitis is inflammation of the appendix. The medical procedure for the departure of the reference area is called an appendectomy. Appendectomy can be performed through an open or laparoscopic medical procedure, and it is the most effective way to prevent complications is to remove the inflamed appendix early by open surgery or laparoscopically. This case was a 14 years old female with abdominal pain and acute appendicitis that underwent surgery shows Occiur patch was the cause of her signs and symptoms of acute appendicitis that performed resection of appendix and discharge healthy. The present study presents a classic case of parasitic appendicitis in a teenage girl and discusses the clinical features, treatment and global burden of disease. Atypical presentations may indicate an unusual anatomical placement of the appendix. Preoperative diagnosis using cross-sectional computed tomography imaging and a thorough understanding of these situations frequently result in early diagnosis and expeditious surgical care. EV was seen in 9.8% of pediatric appendectomies in our study. Pruritus anus, normal WBC count, normal neutrophil count, and normal CRP level at presentation could predict EV infection in children who present with right iliac fossa pain. E. vermicularis is responsible for 7% of acute appendicitis. It is responsible for a significantly higher negative appendectomy rate which if predicted may avoid unnecessary appendectomy and associated morbidity. Enterobius vermicularis associated appendicular colic and acute appendicitis are rarely encountered in the United States. The high rate of inflammation on pathology found among our patients with pinworm appendicitis suggests an association with presentation as acute appendicitis. Enterobius vermicularis is known to be associated with appendicitis, however a causal relationship between Enterobius and appendicitis has not been established. The aim of this study was to explore the relationship between appendiceal Enterobius and histologic appendicitis. Enterobius-associated appendicitis cases and compare them with acute appendicitis cases in terms of parameters such as the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP)-to-lymphocyte ratio (CLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). Enterobius vermicularis infections are usually asymptomatic and may only cause anal pruritis, with occasional reported cases of ectopic migration into the appendix or the female genital tract by adult pinworms.