Schistosomiasis as a rare cause of recurrent acute appendicitis - A case report

We are presenting a case of schistosomiasis in a 41 year old lady who presented with right iliac fossa pain for 3 years. The pain worsened and the frequency increased in the last 3 months prior to referral. The ultrasound was unremarkable. Her bowel habits were normal and there was no vomiting. There was no blood in the stool or in the urine.

The abdomen was soft except on deep palpation. There was slight tenderness in the right lower quadrant. A repeat ultrasound was unremarkable. The full blood count was within the normal range. A diagnosis of recurrent acute appendicitis was made and an interval appendicectomy was performed.

Histopathology results revealed schistosomiasis of the appendix. There was no acute inflammation but there was fibrous obliteration of the distal lumen of the appendix and reactive lymphoid hyperplasia.

This is the first case in a country with relatively clean drinking water. There are no irrigation schemes but there are seasonal rivers and streams. The patient admits to swimming in these streams during childhood. Clinical features of schistosomiasis were not elicited.