Large intestine obstruction complicated with perforation
a rare manifestation of Schistosoma mansoni infection
Keywords:
Schistosomiasis, Colon obstruction, Large intestineAbstract
The authors report a case of a 25 year old Brazilian man with a history of crampy abdominal pain in the left iliac fossa for 2 weeks, abdominal distention, mucous diarrhea and anorexia. The patient presented signs of hemodynamic instability and a hard mass palpated in the left iliac fossa presented peritoneal irritation. At laparotomy, fecal peritonitis and a punched-out perforation of the midsigmoid colon were found. A left hemicolectomy was performed with terminal colostomy. Specimen examination revealed a thickened rectosigmoid wall, narrow lumen and multiple mucosal polyps. Microscopically, chronic granulomatous colitis with Schistosoma mansoni eggs confirmed the etiology. To the authors' knowledge, this is the first case of obstruction complicated with perforation due to mansoni schistosomiasis reported in the literature.
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References
De Cock KM. Hepatosplenic schistosomiasis: a clinical review. Gut 1986;27:734-45.
Cheever AM, Andrade ZA. Pathological lesions associated with Schistosoma mansoni infection in man. Trans R Soc Trop Med Hyg 1967;61:629-39.
Elmasri SH, Boulos PB. Bilharzial granuloma of the gastrointestinal tract. Br J Surg 1976;63:887-90.
Magalhăes A. Polyps of the large intestine. Schistosomotic polyps: a correlation of 500 autopsies and 776 roentgenographic studies. Rev Hosp Clin Fac Med S Paulo 1980;35:94-8.
Pontes J. Rectosigmoidoscopic aspects of mansoni schistosomiasis in Brazil. Dis Colon Rectum 1961;4:343-8.
Gelfand M, Hammar B. Acute intestinal obstruction from a granuloma due to Shistosoma haematobium in the large intestine. Trans R Soc Trop Med Hyg 1966;60:231-2.
Wright SG, Renton P, Swarbrick ET. Stricture of the descending colon due to schistosomiasis. Postgrad Med J 1976;52:602-4.
Elmasalme FN, Raheem MA, Badawy A, Zuberi SR, Matbouli SA. Rectosigmoid bilharzioma causing intestinal obstruction. J Pediatr Surg 1997;32:631-3.
Iyer HV, Abaci IF, Rehnke EC, Enquist IF. Intestinal obstruction due to schistosomiasis. Am J Surg 1985;149:409-11.
Hariton I, Celli BB. Schistosomiasis mansoni as a cause of granuloma of the large intestine - report of three cases. Dis Colon Rectum 1966;9:279-82.
Culliford A, Ibrahim I, Worth MH. Traumatic perforation of the sigmoid colon through schistosomal ulcerations. Am J Surg 1975;129:705-8.
Gambescia RA, Kaufman B, Noy J, Young J, Tedesco FJ. Schistosoma mansoni infection of the colon: a case report and review of the late colonic manifestations. Dig Dis 1976;21:988-91.
Wolfe HRI. The surgical treatment of tropical diseases of the colon and rectum. Proc R Soc Med 1967;60:50-4.
Ming-Chai C, et al. Colorectal cancer and schistosomiasis. Lancet 1981;2:971-3.
Dimmette RM, Elwi AM, Sproate HF. Relationship of schistosomiasis to polyposis & adenocarcinoma of large intestine. Am J Clin Pathol 1956;26:266-9.
