Case Report

Colonic Perforation of Bilharzian Origin. About a Case at The Ndioum Regional Hospital

Authors: Yattara A, Kanté AT, Bangoura MS, Camara FL, Kobina S, Keita AH, Touré A, Dieng M.

DOI: 10.33425/2689-1093.1083

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Abstract

Introduction: Schistosomiasis is a parasitosis caused by a trematode. In Senegal, it is endemic in all regions. The aim of this work was to report a rare case of right colonic perforation secondary to gastrointestinal bilharziasis, with a review of the literature.

Case Report: A 15-year-old patient with no previous pathological history was admitted to the emergency department of the Ndioum regional hospital for abdominal pain with cessation of transit for 4 days. Clinical examination revealed an infectious syndrome, tenderness of the right iliac fossa and right flank, with parietal tenderness in the right iliac fossa and a cry from the umbilicus. Examination of the other systems was unremarkable. Ultrasound examination was consistent with acute appendicitis, with an anteroposterior diameter of 11 mm. Biological tests showed a hyperleukocytosis of 29,000 leukocytes/L and a positive CRP of 96mg/L. Exploration using the Mac Burney approach revealed an inflamed appendix and an inflamed cecum with an area of sphocele.

We decided to convert to median laparotomy, which revealed an inflamed right colon with two areas of perforation on the ascending colon. A right hemi colectomy with ileo-transverse anastomosis was performed. The postoperative course was marked on day 4 by a right pleurisy requiring thoracic drainage. The patient was discharged on postoperative day 16. Pathological examination of the right ileo-colectomy specimen showed suppurative colitis associated with appendicular bilharziasis. The patient was started on praziquantel 1200mg in 2 doses taken 4 hours apart.

Conclusion: Bilharzia is an endemic parasitosis in Senegal. It can evolve into complicated forms, hence the need for regular deworming campaigns.

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