SERIOUS AND RECURRENT INTESTINAL HEMORRHA GE - AN EXCEPTIONAL FORM OFSCHISTOSOMIASIS

Schistosoma mansoni infection is frequent in certain areas of the worl d in which it is endemic. It is characterised by colonic and hepatic l esions. Gastrointestinal hemorrhages due to rupture of esophageal vari ces in case of hepatic involvement or moderate rectal bleeding due to colonic involvement may also be observed. We report a case of colonic Schistosoma mansoni infection presenting exclusively with recurrent ep isodes of serious gastrointestinal hemorrhage without hepatic lesions. All diagnostic investigations were negative. The diagnosis was only e stablished on histological examination of the operative left hemicolec tomy carried out with the utmost emergency for the serious recurrent h emorrhage. Histological examination revealed the presence of mucosal m icro-ulcers, capillary neovascularization in the submucosa and serosa, and the presence of fibrous nodules and giant cell granulomas surroun ding the eggs of Schistosomia mansoni in the serosa. This case is orig inal by its clinical presentation and the difficulty to diagnose the S chistosomiasis.