An unusual case of chronic appendicitis. A case report and literature review

Abstract

Acute appendicitis is one of the most frequent and studied surgical emergencies. In contrast, chronic appendicitis is not well understood at the moment, but the condition begins with partial, transient or recurrent obstruction of the appendicular lumen.A 25-year-old male attended the general surgery department after presenting a 2-month chronic abdominal pain in the right iliac fossa, moderate intensity, oppressive type, without nausea, vomiting or diarrhea. In the absence of any significant previous medical history, laboratory studies were performed without alterations. After requesting a simple abdominal tomography there were findings related to an inflammatory appendiceal process with a thickness of 8 mm and calcification in its wall, without evidence of adenopathies or free fluid. A diagnostic laparoscopy was performed without any incidents whatsoever; although, chronic appendicitis secondary to intraluminal parasitosis was found in histopathological results. There is very little evidence that the presence of parasitosis is a trigger for chronic appendicitis, given the low incidence of chronic appendicitis; however, acute appendicitis may be a common finding. Most of the studies affirm that there is no relationship between parasitosis and the presence of acute appendicitis; nevertheless, the presence of a parasite within a chronic appendix could be the etiological condition.