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Colonic Polyps an Unusual Manifestation of Schistosomiasis

Patient: Male, 24-year-old Final Diagnosis: Large rectal polyps secondary to Schistosoma infection • Unusual colonic polyp caused by Schistoma infection Symptoms: Abdominal pain • bleeding per rectum Medication: During the procedure: Xylocaine local gel • Midazolam inj • Fentanyl inj; For the diseas...

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Autores principales: Al-Zubaidi, Ali Mothanna, Bashanfer, Galal Ahmed, Alqannas, Mashhour H., Atawi, Abdullah Suliman Al
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476750/
https://www.ncbi.nlm.nih.gov/pubmed/32764533
http://dx.doi.org/10.12659/AJCR.923177
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author Al-Zubaidi, Ali Mothanna
Bashanfer, Galal Ahmed
Alqannas, Mashhour H.
Atawi, Abdullah Suliman Al
author_facet Al-Zubaidi, Ali Mothanna
Bashanfer, Galal Ahmed
Alqannas, Mashhour H.
Atawi, Abdullah Suliman Al
author_sort Al-Zubaidi, Ali Mothanna
collection PubMed
description Patient: Male, 24-year-old Final Diagnosis: Large rectal polyps secondary to Schistosoma infection • Unusual colonic polyp caused by Schistoma infection Symptoms: Abdominal pain • bleeding per rectum Medication: During the procedure: Xylocaine local gel • Midazolam inj • Fentanyl inj; For the disease: Praziquantel tab Clinical Procedure: Colonoscopy with endoscopic submucosal resection (EMR) • endoscopic submucosal resection (EMR) Specialty: Gastroenterology and Hepatology • Endoscopy OBJECTIVE: Report of misleading rare disease to avoid an unnecessary invasive intervention BACKGROUND: Although reports of bilharizial colonic polyps are very rare in the literature, we report a case of a large rectal polyp as a manifestation of chronic intestinal bilharzia. A high index of suspicion in an endemic area is the key factor to avoid unnecessary medical interventions. CASE REPORT: We report a case of a 24-year-old male patient who was married, born in Taiz North Yemen, and worked as a military soldier. He presented to our clinic with a complaint concerning intermittent lower abdominal pain and several months of rectal bleeding. A colonoscopy was performed at the Endoscopy Unit of King Khalid Hospital, Najran, Saudi Arabia on September 23, 2019 and results showed 2 large rectal polyps, (measuring 4×3 and 2×3 cm), located 10 cm from the anal verge, having wide bases and irregular surfaces that mimicked dysplastic polyps. Both polyps became elevated after a normal saline/methylene blue injection. An endoscopic mucosal resection was successfully performed with no immediate complications. The histopathology showed benign polyps due to Schistosoma-induced colonic infection. CONCLUSIONS: It is very difficult and challenging to differentiate Schistosoma-induced colonic polyps from other colonic polyps even with an endoscopic evaluation; thus, a high index of clinical suspicion is required mainly in an endemic area, which may prevent the physician from ordering unnecessary interventions and thus avoid severe complications.
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spelling pubmed-74767502020-09-16 Colonic Polyps an Unusual Manifestation of Schistosomiasis Al-Zubaidi, Ali Mothanna Bashanfer, Galal Ahmed Alqannas, Mashhour H. Atawi, Abdullah Suliman Al Am J Case Rep Articles Patient: Male, 24-year-old Final Diagnosis: Large rectal polyps secondary to Schistosoma infection • Unusual colonic polyp caused by Schistoma infection Symptoms: Abdominal pain • bleeding per rectum Medication: During the procedure: Xylocaine local gel • Midazolam inj • Fentanyl inj; For the disease: Praziquantel tab Clinical Procedure: Colonoscopy with endoscopic submucosal resection (EMR) • endoscopic submucosal resection (EMR) Specialty: Gastroenterology and Hepatology • Endoscopy OBJECTIVE: Report of misleading rare disease to avoid an unnecessary invasive intervention BACKGROUND: Although reports of bilharizial colonic polyps are very rare in the literature, we report a case of a large rectal polyp as a manifestation of chronic intestinal bilharzia. A high index of suspicion in an endemic area is the key factor to avoid unnecessary medical interventions. CASE REPORT: We report a case of a 24-year-old male patient who was married, born in Taiz North Yemen, and worked as a military soldier. He presented to our clinic with a complaint concerning intermittent lower abdominal pain and several months of rectal bleeding. A colonoscopy was performed at the Endoscopy Unit of King Khalid Hospital, Najran, Saudi Arabia on September 23, 2019 and results showed 2 large rectal polyps, (measuring 4×3 and 2×3 cm), located 10 cm from the anal verge, having wide bases and irregular surfaces that mimicked dysplastic polyps. Both polyps became elevated after a normal saline/methylene blue injection. An endoscopic mucosal resection was successfully performed with no immediate complications. The histopathology showed benign polyps due to Schistosoma-induced colonic infection. CONCLUSIONS: It is very difficult and challenging to differentiate Schistosoma-induced colonic polyps from other colonic polyps even with an endoscopic evaluation; thus, a high index of clinical suspicion is required mainly in an endemic area, which may prevent the physician from ordering unnecessary interventions and thus avoid severe complications. International Scientific Literature, Inc. 2020-08-07 /pmc/articles/PMC7476750/ /pubmed/32764533 http://dx.doi.org/10.12659/AJCR.923177 Text en © Am J Case Rep, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Al-Zubaidi, Ali Mothanna
Bashanfer, Galal Ahmed
Alqannas, Mashhour H.
Atawi, Abdullah Suliman Al
Colonic Polyps an Unusual Manifestation of Schistosomiasis
title Colonic Polyps an Unusual Manifestation of Schistosomiasis
title_full Colonic Polyps an Unusual Manifestation of Schistosomiasis
title_fullStr Colonic Polyps an Unusual Manifestation of Schistosomiasis
title_full_unstemmed Colonic Polyps an Unusual Manifestation of Schistosomiasis
title_short Colonic Polyps an Unusual Manifestation of Schistosomiasis
title_sort colonic polyps an unusual manifestation of schistosomiasis
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476750/
https://www.ncbi.nlm.nih.gov/pubmed/32764533
http://dx.doi.org/10.12659/AJCR.923177
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