Acute small bowel obstruction due to bilharziasis
Gul, R.; Khalid, K.; Al-Rajhi, M.F.; Bismar, H.A.
Saudi Medical Journal 26(10): 1624-1626
2005
ISSN/ISBN: 0379-5284 PMID: 16228068 Document Number: 589246
A 50-year-old Yemeni male was admitted to the Accident and Emergency Department, Riyadh Medical Complex, Saudi Arabia, with generalized abdominal pain, occasional vomiting, abdominal distention and constipation of one day duration. Abdominal x-ray showed scattered gas fluid levels and mildly distended loops of small bowel. Exploratory laparotomy disclosed distended loops of small bowel with multiple pale nodules on serosal surface, omentum and peritoneal surfaces. One loop of distal ileum was stuck to the pelvic floor with dense adhesions. Gentle releasing of the loop revealed a tight stricture along with serosal nodules and thickened adjacent mesentery. Segmental resection and anastomosis were performed and biopsy from the omentum was obtained. Histopathology of the resected specimen and omentum showed Schistosoma mansoni eggs in muscularis propria with inflammatory cells and fibrosis in the wall of the ileum along with transmural inflammation, consistent with small bowel bilharziasis. The patient was treated with a single course of praziquantel (40 mg/kg). He was discharged in good condition and was doing well without recurrent symptoms after 6 months follow up.