Sigmoid volvulus revealing hidden schistosomiasis: a case report and literature review

Sigmoid volvulus is an uncommon cause of intestinal obstruction, typically affecting older adults. Its association with chronic schistosomiasis is exceptionally rare, and the causal relationship remains unclear. We report a case of sigmoid volvulus in a 22-year-old male immigrant from Guinea, which led to the incidental diagnosis of chronic Schistosoma mansoni infection. The patient presented with abdominal pain, distension, and constipation. Imaging confirmed sigmoid volvulus, and after failed endoscopic decompression, he underwent sigmoid colectomy. Histopathological examination revealed Schistosoma eggs with granulomatous inflammation, confirmed by stool analysis. The patient was treated with praziquantel and recovered uneventfully. This case highlights the diagnostic challenges of schistosomiasis in non-endemic regions, where it may remain undetected until complications arise. Surgeons in such areas should consider schistosomiasis in patients from endemic regions, even when symptoms are nonspecific. Histopathology remains critical for diagnosis, and early treatment can prevent long-term sequelae.