DOCTORS were shocked to discover pinworms living inside a teenager's appendix.

The 15-year-old arrived at A&E doubled over with tummy pain, feeling sick, and unable to eat - all classic signs of appendicitis.

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Despite this, her temperature was normal, and initial tests, including blood work and imaging, were inconclusive.

A pelvic ultrasound showed a small ovarian cyst, and a CT scan revealed mild constipation - but nothing that clearly pointed to appendicitis.

Over the next two days, her symptoms worsened, and doctors from the US decided to remove the appendix as a precaution.

Appendicitis is an inflammation of the appendix, a small, tube-like organ attached to the large intestine.

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It is one of the most common causes of abdominal pain that requires surgery, affecting about one in 20 people, mostly between the ages of 10 and 30.

If left untreated, it can lead to a ruptured appendix, which can cause a life-threatening infection in the abdominal cavity.

After the organ was removed, doctors were shocked to find it riddled with enterobius vermicularis, commonly known as pinworms.

“The pinworm-infested appendix… drove the patient’s initial presentation and clinical deterioration," the medical team from Beckley Appalachian Regional Hospital, reported in .

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Pinworm infections are common, especially among children aged six to 15.

They spread easily through tiny eggs found on contaminated hands, surfaces, or food.

Once eaten, the eggs hatch in the intestines, and adult worms can cause itching around the anus, particularly at night.​

In rare cases, pinworms can cause more serious complications, such as urinary tract infections (UTIs).

In very severe cases, infections in other parts of the body.

According to the NHS, treatment involves a single dose of mebendazole, with a second dose recommended after two weeks if reinfection is suspected.

All household members should be treated simultaneously, even if they are asymptomatic.

Strict hygiene measures are crucial to prevent reinfection, including regular handwashing, daily bathing, and washing bedding and clothing at high temperatures.​

The patient was treated with albendazole, another anti-parasitic medicine, and made a full recovery.

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Doctors stress the importance of considering parasitic infections when diagnosing abdominal pain, especially when classic appendicitis symptoms are missing.

"This case highlights the diagnostic challenge of elucidating Enterobius vermicularis as the likely etiology of a patient presenting with appendicitis,” the report concluded.