Schistosomiasis manifesting as a colon polyp: a case report

Abstract

IntroductionSchistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation.Case presentationWe describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis.ConclusionsShe was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.

Schistosoma “Eggs-Iting” the Host: Granuloma Formation and Egg Excretion

“…One complication observed in patients is the occurrence of colon polyps that are shed and cause intestinal bleeding ( 160 ). Probably this may happen when unsuccessful trapped eggs become calcified, losing their fibrinolytic potential and leading to chronic granulomas as seen in the liver.…”

Intestinal Schistosomiasis: A Rare Cause of Abdominal Pain and Weight Loss

“…In our case, the identification of colonic polyp consisting of schistosoma eggs, absence of other intra-abdominal pathology, and the improvement of her symptoms with anti-schistosomiasis treatment strongly imply the diagnosis of intestinal schistosomiasis. We believe that our case is probably the only patient with intestinal schistosomiasis presenting with abdominal pain and polyps that has ever been reported in U.S. [10]. As shown in our patient and literature, clinical symptoms and laboratory tests are typically not specific enough to aid the diagnosis of intestinal schistosomiasis, therefore, careful history acquisition and egg identification are crucial to establish early diagnosis and prevent complications.…”

Huge bilharzial polyp mimicking colon cancer

“…Atik et al reported an extremely rare presentation in a 25‐year‐old Brazilian patient who presented colonic perforation and fecal peritonitis due to multiple colonic bilharzial polyps, and thick colonic wall perforating into the abdominal cavity was detected in postlaparotomy histopathology. In addition, Issa et al reported large right‐side colonic bilharzial polyp is a 20‐year‐old Ethiopian woman, who presented with long‐standing abdominal pain. Our patient did not report any symptoms suggestive of bilharziasis.…”

“…Although any part of the bowel may be the seat for bilharzial polyps, it is commonly encountered in the rectosigmoid region. However, large polyps were also reported in the ascending colon and the cecum …”

“…However, large polyps were also reported in the ascending colon and the cecum. 5 The symptoms associated with colonic schistosomiasis are nonspecific and may mimic other gastrointestinal pathologies, like nonspecific abdominal pain, diarrhea, constipation, alternating bowel habits, or bleeding per rectum. 6 Atik et al 6 reported an extremely rare presentation in a 25-year-old Brazilian patient who presented colonic perforation and fecal peritonitis due to multiple colonic bilharzial polyps, and thick colonic wall perforating into the abdominal cavity was detected in postlaparotomy histopathology.…”