Schistosomal appendicitis in Qatar: a rare parasitic cause of acute appendicitis in a non-endemic region

TL;DR

A rare case of schistosomal appendicitis was diagnosed in Qatar, highlighting the importance of considering parasitic causes in non-endemic regions.

Contribution

This is the third reported case of schistosomal appendicitis in Qatar, emphasizing its under-recognized nature in non-endemic areas.

Findings

Schistosomal appendicitis was confirmed via histopathology in a patient from an endemic region.

The condition is clinically indistinguishable from typical appendicitis and requires histopathological analysis for diagnosis.

Routine histopathological examination of appendectomy specimens is essential for identifying rare parasitic causes.

Abstract

Acute appendicitis is a common surgical emergency, but its parasitic causes are often overlooked, particularly in non-endemic regions. Schistosomiasis, which affects over 250 million people globally, can rarely lead to schistosomal appendicitis (SA). A 32-year-old Filipino woman presented with acute right iliac fossa pain, vomiting, and loose stools. Clinical and imaging findings were consistent with appendicitis, and she underwent a laparoscopic appendectomy. Histopathological analysis revealed multiple calcified Schistosoma ova in the appendiceal wall, confirming SA. The patient recovered uneventfully and was referred to the Infectious Diseases department for further management. This case represents the third reported instance of SA in Qatar. SA is clinically and radiologically indistinguishable from typical appendicitis and is usually diagnosed retrospectively via histopathology. SA should be considered in the differential diagnosis of appendicitis in migrants from endemic regions. Routine histopathological examination of appendectomy specimens is crucial for accurate diagnosis and appropriate postoperative care.

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