1014 Vermi-Bourne Appendicitis - More Common Than You Might Think

Abstract Aim Enterobius vermicularis is a common parasitic infection, however its direct association with acute appendicitis remains highly debated. Systematic reviews in the African and American continents have identified prevalence of E.vermicularis-associated appendicitis ranging from 33% in Nigeria to 1% in Venezuela with an average global prevalence of 4%. UK rates are poorly documented. We aim to investigate prevalence and histological effects of E.vermicularis associated with acute paediatric appendicitis at a district general hospital. Method A retrospective case series of paediatric patients with aged between 5 and 16 who underwent operative intervention for presumed appendicitis between 01/08/2021 to 31/10/2023 was undertaken. Results Of 132 included patients, 13 patients had histologically proven E.vermicularis (9.8%) and 102 had acute appendicitis (77.3%). 11 of 13 E.vermicularis cases had associated acute appendicitis (84.6%). Majority were male patients (55.3%) with a mean age of 11.8 years. Histology identified serositis in 69.23% and lymphoid hyperplasia in 53.85% of E.vermicularis cases. None presented with acute perforation and majority cases were clinically diagnosed (92.31%) with a 7.69% readmission rate. Conclusions E.vermicularis should be considered as a differential causative agent for appendicitis. A tailored and specific history should be taken keeping a high level of suspicion in the paediatric population. Post-operative advice should include over-the-counter oral mebendazole for the patient and all household family members.