Enterobius Vermicularis: A Cause or an Incidental Finding in Pediatric Appendicitis?

Purpose: The role of Enterobius Vermicularis (E. vermicularis) in the etiology of acute appendicitis is controversial. We aimed to investigate the incidence of E. vermicularis in appendectomy specimens and its contribution in the pathogenesis of appendicitis. Methods: : The files of patients who had E. vermicularis in appendectomy specimens between June 2016 and June 2022 were reviewed retrospectively. The samples of patients whose appendectomy specimens showed E. vermicularis were analyzed in 3 groups according to the results of histopathological evaluation, as reactive lymphoid hyperplasia, acute appendicitis, and perforated appendicitis. Results: : The files of 1334 patients were examined and E. vermicularis was found histopathologically in 24 (1.8%) of them. Fifteen of the patients were boys, 9 were girls, and the mean age was 11.17±2.91 (min: 7 years, max: 17 years). Histopathological examination of appendectomy specimens revealed reactive lymphoid hyperplasia in 15, acute appendicitis in 6, and perforated appendicitis in 3. Only neutrophil counts were significantly different in patients with reactive lymphoid hyperplasia and acute appendicitis (p<0.05). Conclusion: The high rate of histopathologically reactive lymph nodes in appendectomy specimens with E. vermicularis suggests that this parasite was found incidentally in the appendix. Differentiating enterobiosis from true appendicitis may prevent unnecessary appendectomies.