Schistosoma mansoni proctocolitis with polyposis

Abstract

Schistosoma proctocolitis is a rare disease entity, with limited literature on its occurrence. We report the case of a 17 year old male from an endemic area around Lake Victoria, Western Kenya, where detailed disease mapping of Schistosomiasis has been carried out. The patient presented with a seven year history of a protruding rectal mass and occasional hematochezia. Colonoscopy revealed multiple polyps involving the entire colon to the anus, and pathology showed inflammatory polyps secondary to Schistosoma

Colonic Polyps an Unusual Manifestation of Schistosomiasis

“…Intestinal diseases, especially in the colon, are mostly caused by S. mansoni as the most commonly implicated pathogen. The most common histopathological findings from colonic biopsies of patients are S. mansoni ova in the colonic mucosa with no or mild inflammatory cell infiltrates that correlate with the endoscopic appearance in most patients [ 10 – 12 ]. Patients may present with non-specific symptoms, such as lower abdominal pain, occasional diarrhea, and rectal bleeding.…”

Schistosomal (bilharzial) polyps: Travel through the colon and beyond

“…However, no part of the colon is immune against development of S. polyps. The polyps were described in all parts of the colon mainly in the rectosigmoid[ 12 ], but also were described in the caecum[ 13 ], ileocaecal valve[ 14 ], appendix[ 15 ], ascending colon[ 16 ], transverse colon[ 17 ] as well as the descending colon[ 12 ], some reports documented the distribution of S. polyps all through the large bowel starting from the caecum up to the anus during the course of heavy infestations in endemic areas[ 18 ].…”

“…Schistosomiasis in the endemic areas, is associated with development of multiple polyps and multiplicity correlates with the density of infection[ 3 , 18 ]. However, there are many reports that Schistosomiasis can manifest by single colon polyp discovered either incidentally during colonoscopy or complicated[ 13 , 16 , 19 ] even without any clinical manifestations suggestive of Schistosomal infection.…”

“…Schistosomiasis is usually associated with small-sized polyps[ 1 , 3 , 12 ]. However, large-sized S. polyps have been described in many case reports[ 12 , 16 , 18 , 19 ]. We reported earlier[ 20 ] that, no part of the colon was immune against development of large S. polyps.…”

“…Furthermore, Smith et al [ 23 ], described diffuse colonic polypoid masses with dysensteric features, a picture endoscopically indistinguishable from familial polyposis and severe ulcerative colitis. Polyp-like lesion in the appendix manifestated as acute appendicitis was reported in a Chinese woman by Zhu et al [ 15 ], while pan-colonic inflammation and polyposis were described in Kenia by Bosire et al [ 18 ].…”