Wang XY, Hao Y, Wang ZJ, Xu XL, Yang JH. Clinicopathological differences between patients with schistosomal appendicitis and non schistosomal appendicitis: A retrospectively study of past ten years. World J Clin Cases 2025; 13(2): 96557 [DOI: 10.12998/wjcc.v13.i2.96557]
Corresponding Author of This Article
Jiang-Hua Yang, BMed, Chief Doctor, Full Professor, Department of Infectious Diseases, The First Affiliated of Wannan Medical College, No. 2 Zheshan West Road, Yijishan Street, Jinghu District, Wuhu 241001, Anhui Province, China. yjhpath@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 16, 2025; 13(2): 96557 Published online Jan 16, 2025. doi: 10.12998/wjcc.v13.i2.96557
Clinicopathological differences between patients with schistosomal appendicitis and non schistosomal appendicitis: A retrospectively study of past ten years
Xiao-Yi Wang, Yao Hao, Zi-Jian Wang, Xiu-Liang Xu, Jiang-Hua Yang
Xiao-Yi Wang, Yao Hao, Zi-Jian Wang, Xiu-Liang Xu, Jiang-Hua Yang, Department of Infectious Diseases, The First Affiliated of Wannan Medical College, Wuhu 241001, Anhui Province, China
Co-first authors: Xiao-Yi Wang and Yao Hao.
Author contributions: Wang XY, Hao Y and Yang JH participated in the conception and design of the study and were involved in the acquisition, analysis, or interpretation of data; Wang XY wrote the manuscript; Xu XL and Wang ZJ accessed and verified the study data; All authors critically reviewed and provided final approval of the manuscript and all authors were responsible for the decision to submit the manuscript for publication.
Institutional review board statement: This study was approved by the medical ethics committee of Wannan Medical College [Research Proposal Notification of IRB Review Decision (2022) (No. 33)].
Informed consent statement: All study participants, or their legal guardian, provided verbal informed consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All dataset available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jiang-Hua Yang, BMed, Chief Doctor, Full Professor, Department of Infectious Diseases, The First Affiliated of Wannan Medical College, No. 2 Zheshan West Road, Yijishan Street, Jinghu District, Wuhu 241001, Anhui Province, China. yjhpath@163.com
Received: May 9, 2024 Revised: August 27, 2024 Accepted: September 26, 2024 Published online: January 16, 2025 Processing time: 182 Days and 16 Hours
Abstract
BACKGROUND
Chronic schistosomiasis causes multiple organ and multiple system diseases, especially the digestive system. Schistosome eggs are mainly deposited in the stomach, liver and colorectal, but a few eggs are deposited in the appendix and cause disease. At present, there are few studies on schistosomal appendicitis.
AIM
To explore the differences in epidemiological, clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis.
METHODS
The differences of general data, clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed. All patients were divided into two groups for analysis. There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group.
RESULTS
Schistosomal appendicitis accounted for 2.45% of all patients with appendicitis, and the annual proportion in the past decade was 2.2%, 2.9%, 1.8%, 1.9%, 3.4%, 3.1%, 1.9%, 1.6%, 3%, 2.6%, respectively. The prevalence of schistosomal appendicitis was middle-aged and elderly males, with an average age of 61.73 ± 15.335 years. The main population of non-schistosomal appendicitis was middle-aged men, with an average age of 35.8 ± 24.013 years (P < 0.001). The distribution of pathological types of appendicitis was different between the two groups (P < 0.001). The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis [odds ratio (OR) = 0.504; 95% confidence interval (CI): 0.349-0.728; P < 0.001]. The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis (OR = 2.614; 95%CI: 1.815-3.763; P < 0.001). The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of non-schistosomal appendicitis patients (OR = 5.087; 95%CI: 1.427-18.132; P = 0.012). There was no difference in clinical symptoms between the two groups. In the laboratory examination, there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis. The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range. Other statistically significant indicators were in the normal range.
CONCLUSION
Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies, potentially leading to a poor prognosis. Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination. It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis, and to ensure early detection and treatment.
Core Tip: This is a retrospective single-center observational study to investigate clinical and pathological characteristics of schistosomal appendicitis. Schistosomal appendicitis is a serious disease, which is easy to be complicated with intestinal malignant tumors. Schistosomal appendicitis has no specific clinical manifestations and laboratory tests, and the prognosis may be poor. It is more likely to be misdiagnosed and missed diagnosis in clinical work. Although chronic schistosomiasis has decreased year by year, the proportion of schistosomal appendicitis has not decreased in the past decade.
