Colorectal schistosomiasis: clinicopathologic study and management.

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Pathology

Background:

• Colorectal schistosomiasis presents with severe symptoms including dysentery, anemia, and polyps.
• Medical therapy often fails in advanced cases, necessitating alternative management strategies.
• Complications include pericolic masses, schistosomal ulcers, intussusception, and chronic intestinal obstruction.

Purpose of the Study:

• To evaluate the safest and most effective management for colorectal schistosomiasis patients refractory to medical treatment.
• To analyze surgical outcomes in patients with complex intestinal manifestations.

Main Methods:

• Retrospective study of 40 patients with colorectal schistosomiasis.
• Inclusion of patients who failed prior medical therapy.
• Surgical intervention, primarily diverting transverse colostomy, followed by further procedures.

Main Results:

• Patients presented with dysentery, bloody mucus, anemia, polyps, pericolic masses, and schistosomal ulcers.
• Two cases mimicked intussusception and appendicitis due to cecal masses.
• Three patients experienced chronic intestinal obstruction.
• Diverting transverse colostomy proved to be a safe initial surgical approach.

Conclusions:

• Surgical management, initiated with diverting transverse colostomy, is the safest approach for medically unresponsive colorectal schistosomiasis.
• Surgical intervention is crucial for managing severe complications like obstruction and masses.
• Further surgical procedures may be required based on individual patient needs.