PMC7481515_01
(A) CT Abdomen and Pelvis illustrating nodular cecal mural wall thickening measuring up to 14 mm and eccentric mural thickening in the terminal ileum measuring up to 7 mm, with marked surrounding fat stranding and numerous prominent surrounding mesenteric lymph nodes measuring up to 8 mm in the short axis. The surrounding peritoneal lining in the right lower quadrant appeared thickened and nodular. (B) The small bowel was diffusely dilated up to 4.9 cm in diameter with air-fluid levels, worst at the terminal ileum proximal to the cecal thickening.
gr1.jpg
PMC7481515_01_gr1.jpg
fig0005
The initial computed tomography (CT) of her abdomen showed nodular cecal mural wall thickening associated with a partial proximal large bowel obstruction with associated small bowel dilatation (Fig. 1).
(A) Cross-section through colonic stricture showing fibrosis and thickening of the muscularis mucosa, submucosa, and muscularis propria. (B) Calcified Schistosomiasis eggs are identified within the submucosa, (C) associated with a mild, predominately lymphocytic, inflammatory infiltrate. (D) Higher magnification of the Schistosomiasis eggs does not identify any prominent terminal spines.
gr2.jpg
PMC7481515_01_gr2.jpg
fig0010
Final pathology showed intestinal submucosal schistosomiasis with dense distorting fibrosis, focal mucosal ulceration, architectural distortion of the mucosal crypts and villi, and easily identified calcified eggs (Fig. 2).