Isolated Appendiceal Pinworms on Colonoscopy
Stool examination for Enterobius vermicularis is a poor test and yields a positive diagnosis in only 5% to 15% of infected individuals (1). Serial cellophane tape testing, however, has a sensitivity of approximately 90% (2). E vermicularis has also been reported to mimic symptoms of acute appendicitis, although it causing appendicitis remains debated. Fleming et al (3) found 69% of appendix specimens containing E vermicularis did not have appendicitis. A case series by Ariyarathenam et al (4) showed 1 in 6 patients with E vermicularis had appendicitis. Discovering an infestation can be unexpected during appendectomy, and special techniques (eg, 3-endoloop technique, endostapling, port exteriorization) can prevent peritoneal contamination (see Supplemental Digital Content, Video, http://links.lww.com/MPG/A878).