Mazigo Humphrey D, Chandika Alphonce B, Zinga Maria, Heukelbach Jorg, Rambau Peter
Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
Tanzan J Health Res. 2011 Apr;13(2):139-41. doi: 10.4314/thrb.v13i2.64404.
We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of the terminal part of the ileum into the caecum, extending to the ascending colon. Hemicolectomy and end-to-end iliocolostomy was performed. Histological examination of the resected bowel revealed Schistosoma mansoni eggs within the mucosa, submucosa of the ileum, caecum and ascending colon, granulomatous inflammation with foreign body giant cells accompanied by fibrosis and eosinophilic infiltrate into the mucosa. Postoperatively, the patient recovered well. There may have been a synergistic effect of schistosomiasis with other underlying conditions, leading to intussusception. In conclusion, it is important to consider S. mansoni infection as a differential diagnosis for intestinal obstruction in endemic areas.
我们报告一例肠道血吸虫病合并回盲部肠套叠，该肠套叠由血吸虫卵诱导的纤维化导致回肠末端梗阻引起。一名7岁男孩有两个月的腹痛和排便困难病史。超声检查显示侧腹有多个同心圆构成的“甜甜圈”征，肠袢扩张。剖腹探查证实回肠末端套入盲肠，并延伸至升结肠。行半结肠切除术和端端回结肠造口术。切除肠段的组织学检查显示，在回肠、盲肠和升结肠的黏膜及黏膜下层发现曼氏血吸虫卵，伴有异物巨细胞的肉芽肿性炎症，并伴有纤维化以及嗜酸性粒细胞浸润至黏膜。术后，患者恢复良好。血吸虫病可能与其他潜在疾病存在协同作用，导致肠套叠。总之，在流行地区，将曼氏血吸虫感染作为肠梗阻的鉴别诊断很重要。
