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Perianal and perineal pruritus is often associated with Enterobius vermicularis in children. Although this roundworm is common in pediatric practice, most doctors are unaware that it can cause appendicular colic with/or appendicitis, severe urogenital complications, bowel perforation, and peritonitis. We report a case of a young male who presented with signs and symptoms of acute peritonitis. Dur-ing the operation, perforation of the jejunum with a purulent exudate under the transverse colon, a left lateral canal, a Douglas cavity were