Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2024; 16(8): 472-482
Published online Aug 16, 2024. doi: 10.4253/wjge.v16.i8.472
Colonic schistosomiasis mimicking cancer, polyp, and inflammatory bowel disease: Five case reports and review of literature
Sebhatleab T Mulate, Abdulsemed M Nur, Abel T Tasamma, Rodas T Annose, Esmael M Dawud, Kinfe W Ekubazgi, Hailemichael D Mekonnen, Hidaya Y Mohammed, Meron B Hailemeskel, Shimelis A Yimer
Sebhatleab T Mulate, Abel T Tasamma, Department of Internal Medicine, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
Abdulsemed M Nur, Rodas T Annose, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
Esmael M Dawud, Department of Internal Medicine, St Paul’s Hospital Millennium Medical College, Addis Ababa 9086, Ethiopia
Kinfe W Ekubazgi, Department of Internal Medicine, Hawassa University, Hawassa PO Box 05, Ethiopia
Hailemichael D Mekonnen, Department of Internal Medicine, St Paul’s Hospital Millennium Medical College, Addis Ababa 1271, Ethiopia
Hidaya Y Mohammed, Department of Pathology, Addis Ababa University, College of Health Science, Addis Ababa 9086, Ethiopia
Meron B Hailemeskel, Department of Pathology, St Paul’s Hospital Millennium Medical College, Addis Ababa 1271, Ethiopia
Shimelis A Yimer, Department of Pathology, Ethio Tebib General Hospital, Addis Ababa 1111, Ethiopia
Author contributions: Mulate ST contributed to original draft writing, discussion, literature review, and editing; Nur AM contributed to resources, supervision, index case management, editing, validation; Annose RT contributed to index case management, editing, supervision, and validation; Tasama AT contributed to introduction, original draft writing, and editing; Dawud EM contributed to case summary and editing; Mekonnen HD contributed to supervision; Ekubazgi KW contributed to index case management and editing; Mohammed HY, Hailemeskel MB, and Yimer SA contributed to histopathology analysis and description; All authors have read and approved the final manuscript.
Informed consent statement: Verbal and written consent was taken from each patient and all images were shared with each patient’s consent.
Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sebhatleab T Mulate, MD, Doctor, Department of Internal Medicine, Addis Ababa University, College of Health Science, Zambia Street, Addis Ababa 9086, Ethiopia. sebmulate@gmail.com
Received: March 6, 2024
Revised: June 16, 2024
Accepted: June 26, 2024
Published online: August 16, 2024
Processing time: 149 Days and 3 Hours
Abstract
BACKGROUND

Schistosomiasis, officially named as a neglected tropical disease by The World Health Organization, is a serious parasitic disease caused by trematode flukes of the genus Schistosoma. It is a common infectious disease, endemic in more than 78 countries. The disease can involve various organs and poses far-reaching public health challenges.

CASE SUMMARY

Here, we present a series of five patients with variable presentations: an asymptomatic patient who was diagnosed with colonic schistosomiasis upon screening colonoscopy; 2 patients with clinical suspicion of colonic cancer; and 2 patients with a clinical diagnosis of inflammatory bowel disease. All patients were subsequently confirmed to have colonic schistosomiasis after colonoscopy and histopathologic examination. The clinical manifestations, colonoscopy features and histologic findings of the patients are described. Most of the patients showed significant clinical improvement following administration of oral praziquantel.

CONCLUSION

Intestinal schistosomiasis can present with features mimicking other gastrointestinal conditions. This disease should be a diagnostic consideration in patients who live in or have traveled to endemic areas.

Keywords: Schistosomiasis; Schistosoma; Colon; Polyp; Ethiopia; Case report

Core Tip: Schistosomiasis still poses significant morbidity to individuals, especially those in endemic areas. Its variable clinical presentation, protracted course, and nonspecific endoscopic findings frequently lead to erroneous diagnoses. Having a high index of clinical suspicion, actively inquiring about exposure or travel history, utilizing epidemiologic surveys to understand disease distribution, correlating symptoms with basic laboratory tests (especially eosinophil count), and obtaining histopathologic examination of colonic mucosa are essential in making a conclusive diagnosis. Confirming the diagnosis is important, as colonic schistosomiasis can be effectively treated with anthelminthic therapy (praziquantel) obviating the need for unnecessary medical treatments and invasive surgical procedures.