Rectal Perforation Caused by Schistosoma haematobium

Abstract

A 31-year-old woman from Cameroon was admitted to the University of Strasbourg Hospital in December 2007 with pelvic pain and fever that developed over three days. Her condition rapidly worsened and she underwent emergency exploratory celioscopy. Surgeons found peritoneal and retrouterine abscesses. The high rectum had a 4-cm perforation with infiltrated, friable, and irregular edges. A biopsy specimen of this pseudotumoral specimen showed many Schistosoma haematobium eggs with an inflammatory reaction surrounding the eggs. The patient was treated with praziquantel (40 mg/kg/day) for 5 days and a 4-week course of antibiotic therapy. Her progress was good and digestive continuity surgery was performed four months later. Schistosomiasis frequently involves rectal mucosa, but perforation is unusual. Our review of the literature found only two cases of colon perforation associated with S. mansoni infection. To our knowledge, this is the first case of rectal perforation caused by S. haematobium described in the literature.

Jejunal perforation caused by schistosomiasis

“…A review of literature revealed only three cases of colonic perforation associated with intestinal schistosomiasis. 1–3 To our knowledge, jejunal perforation associated with schistosoma has not been previously reported.…”

“…Intestinal perforation is a very unusual complication of schistomiasis and, to date, only three cases of colonic perforation associated with schistosoma infection have been reported in English literature. 1–3 We report an unusual case of jejunal perforation in a South Korean patient, associated with adult worm of schistosoma. To our knowledge, small intestinal perforation associated with adult worm of schistosoma has not been previously reported in literature.…”

Ultrasonographic Diagnosis ofSchistosoma mansoniEggs in Rectum

“…A similar process usually takes place after infection by S. haematobium , with the difference being that the females lay their eggs in the perivesical venous plexus and the eggs are eliminated with urine. Despite being typically associated with the urinary tract, S. haematobium has also been associated with the colorectum, with rectal perforation reported in the literature [6]. …”

Intestinal schistosomiasis presenting as large bowel perforation in an HIV-positive individual

“…1 Bowel obstruction has previously been reported in this patient population but, with the exception of a case from Kuwait of jejunal perforation, 2 a French case of rectal perforation, 3 and a case of sigmoid colonic obstruction resulting in perforation, 4 there are no recorded cases of large bowel perforation in an individual positive for human immunodeficiency virus (HIV) in the literature. We report an unusual cause of large bowel obstruction with associated perforation and discuss the etiology.…”