eP113 - Unusual Presentation of Schistosomiasis as a Rectal Mass in a Young Woman

Sunday, June 2, 2024

9:12 AM – 9:17 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

Tabrez Alam, MD (he/him/his)

General Surgery Resident -- PGY1
NYMC Metropolitan
NYMC Metropolitan
Manhattan, NY, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

VS

Victor Sanchez Alemany, MD

Resident
Metropolitan Hospital
New York, New York, United States

Disclosure information not submitted.
KG

Kelly Gillock, MD

General Surgery, PGY-1
New York City Health and Hospitals - Metropolitan
New York, New York, United States

Disclosure information not submitted.
DH

Donovan Hui, MD

Resident
Metropolitan Hospital Center
New York, New York, United States

Disclosure information not submitted.

Senior Author(s)

JS

Jasvinder Singh, MBBS

Attending Surgeon
Metropolitan Hospital
Valhalla, New York, United States

Disclosure information not submitted.

Author(s)

MW

Marc K. Wallack, MD

Chair of Surgery
Metropolitan Hospital
New York, New York, United States

Disclosure information not submitted.

Purpose/Background: Schistosomiasis is a highly prevalent parasitic disease affecting over 200 million people worldwide. Although urogenital manifestations are more common, intestinal schistosomiasis can present with nonspecific symptoms such as abdominal pain, diarrhea, tenesmus and melena. Rectal masses due to schistosomiasis are exceedingly rare, with paucity of literature examining such presentations.Methods/Interventions: A 21-year-old female who recently moved from Guinea to the United States presented with chronic lower abdominal pain, weight loss, loose bloody stools, dizziness and nausea. Laboratory findings were significant for eosinophilia and severe anemia with an Hb of 4.5, which required a blood transfusion. CT findings revealed a posterolateral rectal mass measuring 3.1 x 3.8 x 3.1 cm approximately 9 cm from the anal verge. Colonoscopy identified a fungating non-bleeding nonobstructive partially circumferential rectal mass. Pathology of the mass revealed chronic rectal mucosal inflammation with Schistosoma ova, eosinophilia and calcifications. The patient was immediately started on Praziquantel.Results/Outcomes: Intestinal schistosomiasis, due to S. mansoni, most often occurs in the rectum and sigmoid colon, and usually presents with nonspecific abdominal pain, diarrhea and hematochezia. The discovery of a rectal mass on imaging and colonoscopy may not be initially suggestive of schistosomiasis, but rather a malignant process. However, histopathology is used to confirm the presence of Schistosoma ova. In prior literature, colonic masses associated with schistosomiasis can appear as polypoid or ulcerating lesions, with biopsies being diagnostic, showing mucosal inflammatory changes and ova.Conclusion/

Discussion: Schistosomiasis should be considered on the differential for patients with a rectal mass and nonspecific lower GI symptoms, especially in patients from endemic areas with histopathologic studies confirming the diagnosis.