Abstract
Background/Aim Although rare, parasitic infection can cause acute appendicitis and result in contamination of the peritonea during appendectomy. The goal of this study was to summarize our experiences with parasitic appendicitis and describe a novel laparoscopic technique to prevent contamination. Method All patients diagnosed with acute appendicitis who underwent appendectomy between January 2016 and January 2017 were included in the study. All appendectomies were performed using the standard three-port laparoscopic method, and a video recording was made of each procedure. Following separation of the mesoappendix, a single endoloop was placed in the base of the appendix, and the appendix was then transected 3-4 mm above the clamp with the aid of a thermal cauterizing/sealing device. The appendix was extracted from the 10 mm trocar hole below the umbilicus and placed inside a bag prepared from a glove. After pathological confirmation of parasitic appendicitis, medical records were retrospectively analyzed in each case for whether peritoneal contamination had occurred or not. Results Out of 97 appendectomies, parasitic infection was observed in 4 cases, as confirmed by pathological examination. In two of these patients, E. vermicularis was detected, while the other two were infected with Balantidium coli. Intraoperative contamination did not occur in any of the cases, and retrospective review of the video recordings indicated no peritoneal contamination. Conclusion As a result of the coagulation and sealing effects of thermal devices, airtight seals were created on the residual appendiceal stumps, and consequently, no contamination was observed in any of the cases.
Highlights
Acute appendicitis is the most common reason for emergency surgery and the most common reason for surgery of the gastrointestinal system (GIS) [1]. e condition is usually caused by increased pressure within the lumen following its obstruction due to fecaloid matter, after which infection develops as a result of bacterial translocation
We retrospectively reviewed all the records of our cases of appendectomy with parasitic infection and, supplementing our data with findings reported in the literature, evaluated procedures to prevent parasitic peritoneal contamination
All patients with a diagnosis of acute appendicitis who underwent appendectomy between January 2016 and January 2017 were retrospectively included in the study. e primary reason for selecting this time period was the fact that all the appendectomy surgeries beginning with the start date were performed by laparoscopy, with video recordings made of the procedures
Summary
Acute appendicitis is the most common reason for emergency surgery and the most common reason for surgery of the gastrointestinal system (GIS) [1]. e condition is usually caused by increased pressure within the lumen following its obstruction due to fecaloid matter, after which infection develops as a result of bacterial translocation. E condition is usually caused by increased pressure within the lumen following its obstruction due to fecaloid matter, after which infection develops as a result of bacterial translocation. E parasite that is commonly encountered following appendectomy is E. vermicularis. Parasites such as Entamoeba histolytica, Schistosoma sp., Taenia sp., Ascaris lumbricoides (Ascaris), and very rarely, Balantidium coli have been reported to cause appendicitis [3, 4]. The role of the parasites in the development of acute appendicitis has not yet been settled, parasites such as E. vermicularis and Ascaris have been reported to obstruct the appendix lumen, resulting in acute appendicitis [5].
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Schedule a callMore From: The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale
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