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• W2921514020 abstract "Introduction Schistosomiasis is a parasitic infection rarely diagnosed in the United States (US). Disseminated infection commonly affects the gastrointestinal (GI) tract and may cause multiple symptoms and rarely polyp formation. Most cases of intestinal polyps have been reported in endemic areas. The most common histology is inflammatory/fibrous. Hamartomatous, hyperplastic, and adenomatous polyps have also been reported. Polyps tend to occur mostly in the rectum. Their malignant potential is controversial with some studies showing an increase in risk after 10 years of infection. We present the unique case of a US-born, 35 year old female with a duodenal polyp of hamartomatous histology with adenomatous changes in the setting of intestinal schistosomiasis. Case Description This is a 35 year old female who presented to the GI clinic with dull epigastric pain and alternating bowel habits for 2 years. She had a past medical history of type 1 diabetes. She was born and raised in the US and traveled outside of the US only twice many years prior. Vital signs and physical exam were unremarkable. All laboratory tests were normal. She underwent an upper endoscopy which revealed a 4.8 cm pedunculated polyp in the second portion of the duodenum. Biopsies revealed a hamartomatous polyp with adenomatous changes, schistosoma parasites within the polyp crypt, and accompanying tissue eosinophilia (figures 1,2). The patient was treated with Praziquantel 20 mg/kg/dose three time per day for 1 day. Her abdominal pain improved soon after treatment. The polyp was subsequently removed. Discussion This case is unique because it presents an example of intestinal schistosomiasis in a non-endemic area. In addition, to our knowledge the occurrence of schistosoma polyps in the duodenum has only been described once in the literature. Furthermore, the hamartomatous histology with adenomatous changes has not been reported in the small bowel. In conclusion, intestinal schistosomiasis should be part of the differential in patients with chronic non-specific GI symptoms in the US, even in the absence of a travel history. If polyps are found they should be removed given the risk of malignant transformation, especially if hamartomatous and/or adenomatous histology in present.2514_A Figure 1. Parasite organisms present in the crypts of the polyp consistent with schistosomiasis accompanied by tissue eosinophilia.2514_B Figure 2. Adenomatous changes arising in a hamartomatous polyp (Peutz-Jeghers type)." @default.
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• W2921514020 date "2018-10-01" @default.
• W2921514020 modified "2023-09-25" @default.
• W2921514020 title "A Hamartomatous Duodenal Polyp Caused by Intestinal Schistosomiasis: A Unique Case" @default.
• W2921514020 doi "https://doi.org/10.14309/00000434-201810001-02513" @default.
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