Intestinal schistosomiasis manifesting as colonic intussusception arising from a mucocele of the appendix: report of a case.
We report a case of intestinal schistosomiasis manifesting as colonic intussusception resulting from a mucocele of the appendix, caused by the obstruction of appendiceal outflow by schistosome egg-induced fibrosis. An 81-year-old woman from China presented with a tender right iliac fossa mass and computed tomography (CT) showed intussusception in the ascending colon. Exploratory laparotomy confirmed an appendiceal mass causing intussusception of the cecum into the ascending colon, with the appendix as the lead point, and lymphnode enlargement. We performed a right hemicolectomy for the appendiceal tumor. However, histologic examination revealed schistosoma eggs within the mucosa, submucosa, muscularis propria, and subserosal fat of the appendix, cecum, and ascending colon, and lymph nodes. The absence of dysplasia in the appendiceal mucosa indicated that the mucocele had developed from fibrosis induced by schistosome eggs obstructing the luminal outflow of mucin. Postoperatively, the patient was given praziquantel and recovered well.
Wong
Mark T C
MT
Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, Singapore.
Goh
Lynne
L
Chia
Kok Hoong
KH
D000369:Aged, 80 and over; D001065:Appendix / Q000469:parasitology*; D002429:Cecal Diseases / Q000469:parasitology*; D005260:Female; D006801:Humans; D007443:Intussusception / Q000209:etiology*; D009078:Mucocele / Q000150:complications*; D012555:Schistosomiasis mansoni / Q000150:complications*; D016896:Treatment Outcome