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.