Limaiem Faten, Hadrich Zied, Hajri Mohamed, Laabidi Taher, Atallah Aziz, Mestiri Hafedh
Faculty of Medicine of Tunis, University of Tunis El Manar, 15, Djebel Lakhdhar Street- 1007 Bab Saadoun, Tunis, Tunisia.
Pathology Department, Hospital Mongi Slim La Marsa, Sidi Daoued - 2046, Tunis, Tunisia.
J Surg Case Rep. 2025 Aug 29;2025(8):rjaf676. doi: 10.1093/jscr/rjaf676. eCollection 2025 Aug.
Sigmoid volvulus is an uncommon cause of intestinal obstruction, typically affecting older adults. Its association with chronic schistosomiasis is exceptionally rare, and the causal relationship remains unclear. We report a case of sigmoid volvulus in a 22-year-old male immigrant from Guinea, which led to the incidental diagnosis of chronic infection. The patient presented with abdominal pain, distension, and constipation. Imaging confirmed sigmoid volvulus, and after failed endoscopic decompression, he underwent sigmoid colectomy. Histopathological examination revealed eggs with granulomatous inflammation, confirmed by stool analysis. The patient was treated with praziquantel and recovered uneventfully. This case highlights the diagnostic challenges of schistosomiasis in non-endemic regions, where it may remain undetected until complications arise. Surgeons in such areas should consider schistosomiasis in patients from endemic regions, even when symptoms are nonspecific. Histopathology remains critical for diagnosis, and early treatment can prevent long-term sequelae.
乙状结肠扭转是肠梗阻的一种罕见病因，通常影响老年人。它与慢性血吸虫病的关联极为罕见，因果关系仍不明确。我们报告一例来自几内亚的22岁男性移民发生乙状结肠扭转的病例，该病例导致了慢性感染的偶然诊断。患者表现为腹痛、腹胀和便秘。影像学检查确诊为乙状结肠扭转，在内镜减压失败后，他接受了乙状结肠切除术。组织病理学检查发现虫卵伴肉芽肿性炎症，粪便分析证实了这一点。患者接受吡喹酮治疗后顺利康复。该病例凸显了非流行地区血吸虫病的诊断挑战，在这些地区，直到出现并发症之前，血吸虫病可能一直未被发现。这些地区的外科医生在面对来自流行地区的患者时，即使症状不具有特异性，也应考虑血吸虫病的可能。组织病理学对于诊断仍然至关重要，早期治疗可预防长期后遗症。
