Abstract
The last-known new occurrence of Schistosoma japonicum (S. japonicum) in the country was in 1978. This report describes a case wherein S. japonicum eggs were detected in the appendix of a patient who underwent laparoscopic appendectomy for acute appendicitis. The previous finding of S. japonicum in Kofu was 69 years previously ; therefore, the case reported in this study is a relatively rare case of appendicitis believed to be caused by S. japonicum eggs.
The patient was a 79-year-old man who was admitted to our department in March 2015 because of right lower abdominal pain, vomiting, and difficulty in dietary intake. Examination of laboratory data revealed increased leucocyte count and C-reactive protein levels. The patient was diagnosed with acute appendicitis, and surgery was scheduled because a swollen appendix associated with fecalith was observed on abdominal computed tomography. A swollen appendix was noted during the surgery ; therefore, laparoscopic appendectomy was performed. Histopathological examination showed lymphoid follicle formation and chronic inflammation of the mucous membrane, fibrous thickening of the appendix wall, and multiple calcified eggs of S. japonicum, suggesting an old granuloma. Postoperative fecal egg examination did not reveal abnormality, although chronic hepatitis and liver cyst were observed on US MRI. No other obvious abnormalities were observed.
