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Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Intestinal schistosomiasis associated with intussusception: a case report
Humphrey D Mazigo1, Alphonce B Chandika, Maria Zinga
1Weill-Bugando University College of Health Sciences, Mwanza, Tanzania. humphreymazigo@bugando.ac.tz
Insights
Intestinal schistosomiasis caused by Schistosoma mansoni eggs can lead to ileocecal intussusception due to fibrosis. This case highlights the importance of considering schistosomiasis in intestinal obstruction diagnoses in endemic regions.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Parasitology
Background:
- Schistosomiasis is a parasitic disease prevalent in endemic areas.
- Intestinal obstruction is a common surgical emergency.
- Ileocecal intussusception is a rare cause of intestinal obstruction in adults.
Observation:
- A 7-year-old boy presented with chronic abdominal pain and constipation.
- Ultrasound revealed characteristic 'doughnut signs' of intussusception.
- Exploratory laparotomy confirmed ileocecal intussusception.
Findings:
- Histological examination of resected bowel revealed Schistosoma mansoni eggs.
- Egg-induced fibrosis in the terminal ileum caused obstruction.
- Granulomatous inflammation, fibrosis, and eosinophilic infiltrate were observed.
Implications:
- Schistosomiasis should be considered in the differential diagnosis of intestinal obstruction in endemic areas.
- Parasitic infections can lead to rare surgical complications like intussusception.
- Early diagnosis and treatment of schistosomiasis may prevent such complications.
Abstract:
We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of the terminal part of the ileum into the caecum, extending to the ascending colon. Hemicolectomy and end-to-end iliocolostomy was performed. Histological examination of the resected bowel revealed Schistosoma mansoni eggs within the mucosa, submucosa of the ileum, caecum and ascending colon, granulomatous inflammation with foreign body giant cells accompanied by fibrosis and eosinophilic infiltrate into the mucosa. Postoperatively, the patient recovered well. There may have been a synergistic effect of schistosomiasis with other underlying conditions, leading to intussusception. In conclusion, it is important to consider S. mansoni infection as a differential diagnosis for intestinal obstruction in endemic areas.
