[Parasitic infection causing appendicitis]

Retrospective analysis of the medical records of patients who underwent acute appendectomy in the Gastrointestinal Surgery Department of the Desgenettes Military Hospital in Lyon, France from the 1st of November 2009 to the 21th of February 2011, turned up two cases of appendicular parasitosis for a prevalence of 3.3%. Both patients presented acute appendicular oxyuriasis caused by Enterobius vermicularis that was discovered inadvertently after appendectomy. This unexpected diagnosis raises questions about the exact role of parasites in the physiopathology of appendicitis. Though appendicitis is the most common surgical emergency in France, appendix vermicularis is rare. In comparison, developing countries and particularly endemic areas such as sub-Saharan Africa show considerably higher appendicular parasitosis prevalence rates and greater variety in the parasites involved. The purpose of this article is to describe the different parasites with potential to affect the appendix, to discuss the different pathophysiological mechanisms underlying acute appendicitis, and to recall the need for medical treatment after appendectomy.