Enterobius vermicularis causing acute appendicitis, a case report with literature review.

INTRODUCTION: Enterobius vermicularis is one of the commonest parasitic infestations worldwide but its association with acute appendicitis remains controversial. It is very rarely encountered during appendectomy. The aim of this paper is to report a case of acute appendicitis caused by Enterobius vermicularis. A 23-year-old housewife presented with a right lower abdominal pain for the past 8 h. Clinical examination revealed right iliac fossa tenderness upon palpation and rebound tenderness upon release. The patient was diagnosed as a case of suspected acute appendicitis. The patient was anesthetized and intubated. Delivery of the vermiform appendix done through right grid iron incision. Intra operatively an inflamed appendix obstructed by Enterobius vermicularis was noted. CONCLUSION: Enterobius vermicularis can habit the appendix and induce the signs and symptoms of A.A with or without actual histopathological acute appendicitis. The treatment of choice is surgical resection of the appendix.

Retroperitoneal lipoma; a benign condition with frightening presentation.

INTRODUCTION: lipoma is the most frequent soft tissue tumor in adults. Its occurrence in the retroperitoneal region is extremely rare. The aim of this study is to report a case of retroperitoneal lipoma with a literature review. PRESENTATION OF CASE: A 34-year-old female presented with abdominal distension and severe back pain for one year duration. She also reported weight loss and constipation. The examination revealed asymmetrical abdominal distension and everted umbilicus. There was a big irregular mass occupying the whole abdomen reaching into the xiphisternum, firm in consistency, smooth surface, and well defined borders. Abdominal ultrasound demonstrated a large retroperitoneal heterogeneous mass. Computed tomography (CT) scan showed a large well defined hyperechoic mass with fibrous septa extending from the left ovary up to the diaphragm. Exploratory laparotomy revealed a giant clearly demarcated fatty tumor adherent to the retroperitoneal fatty tissues. The histopathological examination of the specimen confirmed the diagnosis of the retroperitoneal lipoma. DISCUSSION: Retroperitoneal lipomas have been reported in various age groups; namely children, middle and old age patients. Based on the characteristic radiological features of the tumor, enormous diagnostic work-up is not justified. CONCLUSION: Retroperitoneal lipoma is a very rare variant of lipoma, presents with various signs and symptoms that may be misleading. Radiologic imaging especially CT scan is the diagnostic tool of choice. Surgical resection is the main modality of management.