Pasupati, Thanikachalam M.; Yothasamutr, Kasemsuk; Mak Joon Wah; Emilia, Sharifah; Palayan, Kandasamy
January 2007
Malaysian Journal of Medical Sciences;Jan2007 Supplement, Vol. 14, p125
Academic Journal
Introduction: Appendicitis has a worldwide prevalence and affects all age groups. The aetiology of acute appendicitis is still much debated, many factors have been suggested. The pathology is likely to be due to obstruction of the lumen of the appendix. Parasites, both helminths and protozoa have been suggested to be the cause of acute appendicitis. Studies have demonstrated that parasites were present in the appendix specimens removed from surgery. The objective was to determine the prevalence of parasitic infections in a double study examining both the tissue sections and also the luminal contents in appendices removed during appendectomy. Methodology: One hundred appendectomy specimens were taken from Batu Pahat Hospital. Three bits of tissue from each appendix, two from the body and one from the tip were taken for histopathological analysis. Tissue specimens were sectioned at 4 _m and stained using haematoxylin and eosin staining method. The tissue sections were classified on their degree of inflammation as per standard criteria. They were classified as early acute, acute, acute suppurative or chronic inflammation. Luminal contents were stored in both 10% neutral formalin and polyvinyl alcohol and stained by both trichrome and modified Ziehl-Neelsen methods. Results: Sixteen percent of the cases were positive for parasites. Most of the parasites were detected in the luminal content. In cases that were positive for parasites, 81.25% occurred in patients aged 30 years old or younger. In addition, acute appendicitis was seen in 81.25% of cases that were positive for parasites. Helminths were not detected in the study, only protozoa were present. Unusual parasites that had rarely been reported were detected in this study. This includes Blastocystis hominis, Isospora belli and Microsporidia. Conclusion: Detection of parasites in 16% of the cases was considered significant as previous studies did not show such a high incidence. Examination of the luminal content has proven to be valuable as most cases of parasites infection were detected in the luminal extract. Statistical analysis did not show association between acute appendicitis and parasitic infection. In conclusion, a larger sample size should be used in future studies to be able to draw absolute conclusions.


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