Schistosomiasis associated with rupture of the appendix in pregnancy

Acute appendicitis is among the most common indications for exploratory laparotomy during pregnancy. Although usually pyogenic in origin, parasitic infections account for a small percentage of cases. We report here the association of pregnancy and appendicitis caused by Schistosoma japonicum. Schistosomiasis is a very common complication of pregnancy, with 250,000,000 persons infected worldwide, including 20% of pregnant women living in hyperendemic areas. Schistosome egg masses can lodge throughout the body and cause acute inflammation of the appendix, fallopian tube, liver, and spleen. Congestion of pelvic vessels during pregnancy facilitates passage of eggs into the villi and intervillous spaces, causing an inflammatory reaction. Fetal anoxia and subsequent death has been attributed to heavy infestation of the placenta. Tourism, far-ranging military actions, and immigration make this disease a potential challenge for practitioners everywhere.