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Schistosomiasis Presenting As Colonic Polypoid Masses In a Nigerian Patient

A. Akere1, A.O. Oluwasola2, T.O. Fakoya1 and A. Lawan2

Depts. of Medicine1 and Pathology2, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Nigeria.

ABSTRACT

Intestinal Schistosomiasis is a serious disease and is commonly produced by S. mansoni and japonicum. The presence of viable ova of the organism in the colon elicits inflammation, formation of  granuloma, ulcers, haemorrhage and colonic fibrosis with subsequent longterm sequelae. Schistosoma mansoni is endemic in the Middle East, Africa, Central and South America. This is a case of  a Nigerian with colonic polypoid masses which turned out to be Schistosomal mansoni infection.

Keywords: Colonic polypoid masses, Schistosoma mansoni, Nigerian patient


INTRODUCTION

There are five species of Schistosoma that cause human Schistosomiasis. These are the intestinal species: Schistosoma mansoni, japonicum, mekongi and intercalatum, and the urinary species: Schistosoma haematobium1. Infective cercariae released from infected freshwater snails initiate human infection through penetration of intact skin. Sexually mature worms then migrate to the venous system of the intestine (for the intestinal species) or urinary bladder (for the urinary species) where ova are deposited.1

About 200-300 million individuals are thought to be infected in the Caribbean, South America, Middle East, Africa and Southeast Asia. Schistosoma mansoni is endemic in the Middle East, Africa, Central and South America, while S. japonicum is common in the Philippines, Thailand and China. Schistosoma intercalatum is found mostly in Africa.2

Schistosomiasis is a serious disease. Intestinal disease is commonly produced by S. mansoni and japonicum. Viable ova of the organism in the colon produce inflammation, formation of granuloma, ulcers, haemorrhage and colonic fibrosis with subsequent long term sequelae.3

A colonic polyp represents a mass of tissue protruding into the colonic lumen. The two major groups of colonic polyps are, the neoplastic (benign and malignant) and the non-neoplastic (hyperplastic, Peutz-Jeghers and inflammatory). Although, majority of patients with colonic polyps are asymptomatic, some patients may present with occult or overt lower gastrointestinal bleeding, flatulence, diarrhea and constipation.4

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Correspondence

Dr. Adegboyega Akere, 

Dept. of Medicine,

College of Medicine, 

University of Ibadan/University College Hospital, 

Ibadan, Nigeria.

P.O. Box 28829, Agodi, Ibadan

E-mail: adeakere@yahoo.co.uk

Tel: +2348033257211