AB033. SOH26AB_0411. A need for protocol reform?—Enterobius vermicularis masquerading as inflammatory bowel disease: case reports
Paediatrics Session

AB033. SOH26AB_0411. A need for protocol reform?—Enterobius vermicularis masquerading as inflammatory bowel disease: case reports

Wame Majeremane1, Ellen Schuijt1, Mohamed Ismaiel1, Iffah Ja’afar1, Eibhlin Burn Beattie1, Tara Connelly1,2

1Department of Surgery, University Hospital Limerick, Limerick, Ireland; 2Health Research Institute (HRI), University of Limerick, Limerick, Ireland

Background: Enterobius vermicularis is a relatively common intestinal helminth, with an increased prevalence in the paediatric population. When symptomatic, cases can mimic serious gastrointestinal pathologies. In select cases, paediatric presentations of abdominal pain and weight loss trigger investigations for inflammatory bowel disease (IBD), particularly when faecal calprotectin is elevated; however, routine stool polymerase chain reaction (PCR) testing for parasites is not widely used.

Case Description: Three paediatric patients (two male and one female; age range, 10–15 years) were referred to the paediatric surgery special interest team for evaluation of possible IBD. One had a 3-year history of per-rectal bleeding and increased bowel movements up to five times daily. Another had two hospital admissions for severe abdominal pain and alternating bowel habits. The last presented 1 week post-diagnostic laparoscopy and appendectomy under adult services, with left iliac fossa pain, despite a normal diagnostic work-up. All three patients had elevated faecal calprotectin. Two underwent colonoscopy, while the third had a flexible sigmoidoscopy. In all three cases, endoscopy revealed multiple Enterobius vermicularis with no features of IBD macroscopically or microscopically. Symptom resolution occurred after standard anti-helminthic therapy.

Conclusions: Enterobius vermicularis can mimic paediatric IBD, producing non-specific colitis symptoms and raised faecal calprotectin. These cases demonstrate how the absence of routine stool PCR testing for parasites can lead to unnecessary invasive investigations, including colonoscopy and even laparoscopy. We advocate for guideline reform to incorporate early stool testing for ova, parasites, and PCR-based detection in children presenting with unclear gastrointestinal symptoms before proceeding to invasive diagnostics.

Keywords: Colonoscopy; Enterobius vermicularis; fecal calprotectin; inflammatory bowel disease (IBD); case report

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab033
Cite this abstract as: Majeremane W, Schuijt E, Ismaiel M, Ja’afar I, Beattie EB, Connelly T. AB033. SOH26AB_0411. A need for protocol reform?—Enterobius vermicularis masquerading as inflammatory bowel disease: case reports. Mesentery Peritoneum 2026;10:AB033.

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