The pinworm Enterobius vermicularis is the most common parasite reported to be associated with appendicitis. It frequently occurs in children between the age of 5 to 10 years. The aim of our study is to focus on the relationship between the pinworm and acute suppurative perforating appendicitis. Case series: 4 children from rural areas of Upper Egypt with mean age 11 years presented to emergency department Aswan and Assiut universities hospitals during the period from March 2016 to January 2017

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... complained of right lower quadrant abdominal pain. The appendix in all children was perforated at the base or the middle of the appendix with mobile pinworm was noted moving around the perforated edge. Discussion: Pinworm was associated with different pathologic changes ranging from lymphoid hyperplasia, acute appendicitis, and suppurative appendicitis to a normal appendix. It is wrangling whether pinworm can cause appendicitis or if they are an incidental finding during an appendectomy. Conclusion: The awareness of pinworm and its preventive measures should be delivered to school children and their mothers to overcome the risk of infection and its dangerous drawback. The importance of histopathological and faecolith examinations to the resected appendix specimens to detect the correct incidence of pinworm causing appendicitis in Egypt. No ethical approval has been applied for this case series study, only the written and oral consent by the relatives of the patients. Consent A written consent has been obtained from the patients' relatives for operative intervention and for the publication of this case series. Tandan T, Pollard AJ, Money DM, Scheifele DW (2002) Pelvic inflammatory disease associated with Enterobius vermicularis. Arch Dis Child 86: 439-440.