APPENDICITIS AND SCHISTOSOMIASIS - DIAGNO SIS BY FROZEN-SECTION BIOPSIES

The association of appendicitis with schistosomiasis in the appendix i s extremely rare in France. We report herein a new case in which the d iagnosis was made, in the presence of pseudo-tumoral appendicitis, by frozen section biopsies. The patient presented with a typical acute ap pendicitis, without urinary symptoms, and with granulocytosis (14000 w hite cells/mm3, without eosinophilia). At laparotomy, the appendix was voluminous, with necrotic abscess, and lymph node masses were noted o n the greater omentum. Frozen section biopsies of an omental tumor sho wed schistosoma eggs, malignant cells. Appendicetoomy and partial omen tectomy were performed. Postoperative course was uneventful. Pathologi c examination of the resected specimen showed schistosoma eggs in all layers of the appendix, and in the omentum. Final diagnosis was establ ished by positive serology and by findings Schistosoma haematobium egg s in the urine. The patient was treated postoperatively by praziquante l. In conclusion, in case of acute appendicitis, with pseudotumorous a ppendix and lymph node masses, even with poor epidemiological findings on the clinical history, frozen section biopsies can sometimes establ ish the diagnosis of schistosomiasis with appendicitis, and avoid unju stified bowel resection.