الفهرس 
Histopathology of appendixOnly 14 pages are availabe for public view
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Abstract
In Egypt, intestinal parasitic infections continue to be a major public health problem especially among children. Although mortality from such infections is low, yet it leads to malnourishment, iron deficiency anemia among this age group. Consequently, it may decrease physical activity, physical fitness, school performance and school attendance.
School children repeatedly exposed to intestinal protozoa due to poor personal hygiene, poverty and inadequate health education. Recently, several protozoa such as Cryptosporidium are emerging intestinal protozoa of human. In Egypt, Cryptosporidium was the most prevalent coccidian protozoan parasite detected among healthy children.
The incidence rate of coccidian infection is raising, so, practitioner should be aware of this potential diagnosis when evaluating a patient with acute appendicitis.
Intestinal parasitic infections could be a cause of other health problems such as intestinal obstruction, cholicystitis and appendicitis. Therefore the present work was designed to investigate the prevalence of parasitic infections among appendectomised school age children at Student’s Hospital in Alexandria by stool analysis. It also aimed to estimate the prevalence of parasitic infections in the content of the appendectomy specimens. Moreover the parasitic pathological lesion in the appendectomy specimens, was studied.
The study was carried out in the surgery department in Alexandria Student’s Hospital which was visited every other day. All the appendectomised cases were included till the required sample size is reached (260 cases).
All the children were subjected to the following:
1- An interviewing questionnaire was designed to collect the data from the mothers of the target children, it included demographic data such as age, sex, name, level of education, and occupation of their parents. Housing conditions regarding crowding index, source of water supply. Clinical data such as abdominal colic, vomiting and diarrhea.
2- A single stool sample was obtained from each child and each sample exposed to:
• Aportion of stool sample was used fresh in agar plate culture technique for detection of Strongyloides stercoralis larvae. A second portion of fresh stool specimen was used to prepare thin smears which stained by trichrome stain to detect intestinal protozoa. Another portion of the stool specimen was preserved in 10% formalin and prepared later by formol ether concentration technique to diagnose intestinal parasitic ova and cysts.
3- Blood samples were collected and complete blood picture was done to detect anaemia, leucocytosis and eosinophilia.
4- Appendectomy specimens were subjected to the following:
• Parasitological examination “formol ether concentration technique” for the faecal content of the appendix.
• Microscopic examination of the sections stained by hematoxylin and eosin stain to detect inflammation, granuloma, eosinophilia and parasitic infection of the appendix. The results of the present study are summarized as follow:
1- Out of two hundred and sixty appendectominsed school age children, intestinal parasitic infection were detected in 149 (57%) cases.
2- Protozoa recorded the highest percentage of infection as it represented 69% of cases followed by helminthic infection 21.5%.
3- Cryptosporidium ranked the first protozoal infection its prevalence was 27% followed by Entamoeba histolytice (13.5%) then Cyclospara (11.2%). Percentages of Giardia lamblia, Entamoeba coli, and Microsponidia were 10.4, 6.9 and 0.4 respectively.
4- As regards helminthes, higher percentages of helmithic infection were Enterobius vermicularis as it represented 9.2% of examined cases, and Ascaris lumbnicoides was 5.6%. While as Trichuris trichiura, Schistosoma mansoni and Hymenolepis nana showed lower percentages 2.7 % 2.3% and 1.2% respectively.
5- As regards the gender, there was no significant difference between both sexes in distribution of intestinal parasites (♂ 58.0% and ♀ 56.4%).
6- Regarding age, the results showed that the percentage of infection among appendectomised children was higher among age group less than 10 years (64.3%) followed by age group from 10-14 years, lastly age group more than 15 years (54.8%).
7- As regards the education level of mothers, there was no statistical significant difference between groups of children belonging to mothers who were illiterate or just read and write 48.78% or those who had higher education 58.8%.
8- The percentage of protozoal infection by using trichrome stain was higher than that by using formol ether.
9- Pathological examination of the resected appendices showed 15% parasitic infections among appendectomised children, some cases showed double infections.
10- As regards the pathological findings of the resected appendices, reactive follicular hyperplasia was the major pathological finding as it represented about 50% of cases followed by acute suppurative appendicitis.
11- The majority of appendices that showed parasitic infection accompanied by reactive follicular hyperplasia (74.4%) while 30.8% had acute suppurative appendicitis.