The gravid adult female Enterobius vermicularis pinworm may travel to other sites other than the rectum. One of the more common sites is the appendix.
Both adult worms and eggs can be found in the appendix. Eggs alone in the appendix indicate that a worm had been there but left.
In some situations the presence of pinworms may be causative for appendicitis while in other situations it may be an incidental finding. Some patients will present with chronic or recurrent episodes of right quadrant pain.
Patient
Appendix
E. vermicularis
Interpretation
right lower quadrant pain or appendicitis
noninflamed
worm present
worm movements misinterpreted as appendicitis
right lower quadrant pain or appendicitis
inflamed
worm or eggs present
either appendicitis triggered by worm, or worm incidental
incidental appendectomy
noninflamed
worm or eggs present
incidental infestation
right lower quadrant pain or appendicitis
inflamed
absent
usual appendicitis
The inflammatory response to E. vermicularis may include:
(1) none
(2) acute
(3) eosinophilic
(4) chronic with fibrosis
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