Appendiceal pinworms (pdf io)

Appendiceal Pinworms Ismael Mora-Guzmán, M.D., and Ana Rodriguez-Sanchez, M.D March 29, 2018 N Engl J Med 2018; 378:1232 DOI: 10.1056/NEJMicm1713306 A 45-year-old man with a 1-day history of abdominal pain [đau bụng] and loss of appetite [giảm thèm ăn, chán ăn] presented to the emergency department [khoa cấp cứu] He did not have a fever [sốt] Physical examination [thăm khám lâm sàng] revealed tenderness [đau, không nên nhầm lẫn với pain [đau], pain nhận thức bệnh nhân tenderness dấu hiệu bác sĩ lâm sàng tìm thấy khám] in the right lower quadrant [phần tư phải dưới] of the abdomen [bụng] Rebound [phản ứng dội] was present; Blumberg’s sign [also referred to as rebound tenderness] was negative [âm tính] Laboratory results [kết phòng thí nghiệm (cận lâm sàng)] included a normal white-cell count [đếm bạch cầu], with 82% neutrophils [bạch cầu trung tính] Abdominal ultrasonography [siêu âm bụng] was performed, but the results were inconclusive [không kết luận] with regard to the presence or absence of appendiceal inflammation [viêm ruột thừa] An appendectomy [phẫu thuật cắt ruột thừa] was performed The appendix [ruột thừa] was grossly normal [bình thường mặt đại thể], but pathological analysis [phân tích bệnh học] revealed the presence of Enterobius vermicularis [giun kim] in the appendiceal lumen [lòng ruột thừa] (Panels A and B, hematoxylin and eosin) and mild inflammation [viêm nhẹ] of the mucosa [niêm mạc] E vermicularis, known as pinworm, is a nematode [ngành giun tròn – roundworms] that is most commonly found in young children, although adults can also be infected [nhiễm] The gravid [có chửa] female pinworm attaches to tissue near the cecum [manh tràng] and migrates [di cư] to the anus [hậu môn] to deposit its eggs, which can cause perianal pruritus [ngứa quanh hậu môn] Autoinfection [tự nhiễm] and transmission [truyền] occur through the ingestion of eggs from contaminated hands [bàn tay bị nhiễm bẩn], bathroom fixtures, bedding, food, and other sources It is difficult to determine definitively [xác định cách chắn] whether the presence of pinworm in the appendix was the cause of the patient’s presenting symptoms [triệu chứng] or was an incidental finding After the appendectomy, the patient and his family were treated with mebendazole At follow-up months after surgery [phẫu thuật], the patient was asymptomatic [khơng có triệu chứng] Ismael Mora-Guzmán, M.D Ana Rodriguez-Sanchez, M.D Hospital Universitario de la Princesa, Madrid, Spain ... performed, but the results were inconclusive [không kết luận] with regard to the presence or absence of appendiceal inflammation [viêm ruột thừa] An appendectomy [phẫu thuật cắt ruột thừa] was performed... analysis [phân tích bệnh học] revealed the presence of Enterobius vermicularis [giun kim] in the appendiceal lumen [lòng ruột thừa] (Panels A and B, hematoxylin and eosin) and mild inflammation