Open AccessRare cause of right iliac fossa pain in a UK patient
Author(s) -
Khurram Shahzad,
Mohamed Elmedani,
Smitha Mathew,
Ioannis Peristerakis
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-234694
Subject(s) - medicine , iliac fossa , ascending colon , praziquantel , surgery , colonoscopy , schistosomiasis , gastroenterology , radiology , colorectal cancer , cancer , helminths , immunology
A 62-year-old Asian man presented with a 3-month history of right iliac fossa pain which had progressively worsened over the last 3 weeks. All blood parameters were found to be unremarkable except for mildly elevated erythrocyte sedimentation rate. CT imaging demonstrated thickening of the ascending colon and caecum. Colonoscopic biopsies showed submucosal granulomas with features suggestive of schistosomiasis and parasite serology was positive for Schistosoma antibodies. He was treated with praziquantel and showed subsequent symptomatic and radiological improvement. However, he represented nearly 2 years later and underwent a right hemicolectomy for small bowel obstruction. The resected bowel showed an inflammatory caecal mass and a terminal ileal adenocarcinoma.