Faecolith Examination for Spectrum of Parasitic Association in Appendicitis

Abstract

Background: The appendix is a vestigial organ which is infiltrated by faecal material, microbes and parasites. The most important aetio-pathology of appendicitis is obstruction of its lumen, by a faecolith. This results from accumulation and inspissation of faecal matter around vegetable fibres. The cause for appendicitis is numerous and one among them is parasitic infestation. Aims: To analyze the faecolith present in the appendectomy specimen for parasites and to compare the results in fresh and preserved specimens. Materials and Methods: Patients with acute/chronic appendicitis were subjected for surgery and the appendectomy specimens were collected in saline and formalin suspensions, for preservation purposes. The lumen was washed with normal saline and contents were collected and wet mount preparations were examined under low and high power microscopy. Results: Among 100 specimens 48 faecolith analyses proved to be positive for parasitic association, giving 48% positivity, which is quite high. The commonest isolate was followed by mixed infection. In our study we observed that saline preparations were easy for handling and we were also able to demonstrate the undistorted morphology of parasite better than formalin preserved specimens. Conclusion: This study reveals the importance of analyzing the appendectomy specimen for understanding the etiopathogenisis of appendicitis in spite of having a negative stool microscopy. A post surgical analysis of appendectomy specimen may surprise you with different etiological agents as confirmed by our study.

Keywords

• appendicular lumen
• faecolith
• parasites
• inflammation and microscopy