Schistosomal appendicitis.

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.