Case report: A rare cause of acute appendicitis due to adult Ascaris lumbricoides in a 10-year-old child from Ethiopia.

introductionAcute appendicitis is the acute inflammation of the vermiform appendix. Several etiologic factors, including intestinal helminths, can cause it. Ascaris lumbricoides, a common intestinal worm with several manifestations, can cause acute appendicitis. CASE PRESENTATION: The case presents a 10-year-old male child with signs and symptoms of acute appendicitis which was confirmed by ultrasound. During appendectomy, adult Ascaris lumbricoides was removed from the acutely inflamed appendix and was found to be the cause of the appendicitis. About 100 mL of thin pus was also evacuated. The patient was discharged with an antihelminthic drug. DISCUSSION: The pathophysiology of acute appendicitis is primarily linked to luminal obstruction, with various environmental, genetic, and infectious agents acting as potential triggers. Obstructing agents include lymphoid hyperplasia in children, fecaliths, tumors, and helminths, which increase intraluminal pressure and compromise mucosal blood supply, leading to ischemia and subsequent microbial invasion of the appendiceal wall. Diagnosis relies on clinical presentation-characterized by right lower abdominal pain, nausea, vomiting, and anorexia-along with laboratory findings such as leukocytosis and imaging techniques like ultrasound. Ascaris lumbricoides is highlighted as a significant helminth that can cause appendicitis, particularly in endemic regions, where it may be transmitted through oral ingestion of eggs. Management typically involves appendectomy, and in cases involving Ascaris lumbricoides, anthelmintic treatment is necessary to eliminate the parasite from all potential sites.

conclusionThis case raises the importance of considering helminths, specifically Ascaris lumbricoides, as a cause of acute appendicitis, especially in endemic areas.