Atik F A, Lopes Filho G J, Linhares M de M, Seda Neto J, Mansur N S
Department of Surgery, Universidade Federal de São Paulo/Escola Paulista de Medicina, Brazil.
Sao Paulo Med J. 1998 Jul-Aug;116(4):1781-3. doi: 10.1590/s1516-31801998000400008.
The authors report a case of a 25 year old Brazilian man with a history of crampy abdominal pain in the left iliac fossa for 2 weeks, abdominal distention, mucous diarrhea and anorexia. The patient presented signs of hemodynamic instability and a hard mass palpated in the left iliac fossa presented peritoneal irritation. At laparotomy, fecal peritonitis and a punched-out perforation of the midsigmoid colon were found. A left hemicolectomy was performed with terminal colostomy. Specimen examination revealed a thickened rectosigmoid wall, narrow lumen and multiple mucosal polyps. Microscopically, chronic granulomatous colitis with Schistosoma mansoni eggs confirmed the etiology. To the authors' knowledge, this is the first case of obstruction complicated with perforation due to mansoni schistosomiasis reported in the literature.
作者报告了一例25岁的巴西男子，其有左髂窝痉挛性腹痛病史2周，伴有腹胀、黏液性腹泻和厌食。患者出现血流动力学不稳定的体征，在左髂窝可触及一个硬肿块，伴有腹膜刺激征。剖腹探查时，发现粪性腹膜炎和乙状结肠中部的一个穿孔。行左半结肠切除术并做末端结肠造口术。标本检查显示直肠乙状结肠壁增厚、管腔狭窄和多个黏膜息肉。显微镜检查发现慢性肉芽肿性结肠炎伴有曼氏血吸虫卵，证实了病因。据作者所知，这是文献中报道的首例因曼氏血吸虫病导致梗阻并发穿孔的病例。
