Unusual cause of lesions in the descending duodenum and liver: A case report and review of literature

doi:10.12998/wjcc.v6.i11.472

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Oct 6, 2018; 6(11): 472-476
Published online Oct 6, 2018. doi: 10.12998/wjcc.v6.i11.472

Unusual cause of lesions in the descending duodenum and liver: A case report and review of literature

Zhuang-Long Xiao, Ke-Shu Xu, Yu-Hu Song

Zhuang-Long Xiao, Ke-Shu Xu, Yu-Hu Song, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

Author contributions: Xiao ZL, Xu KS and Song YH collected the case data; Song YH and Xiao ZL wrote the manuscript.

Supported by National Natural Science Foundation of China, No. 81270506 and No. 81570555; Clinical Research Physician Program of Tongji Medical College, No. HUST (2017).

Informed consent statement: All patients completed informed consent forms.

Conflict-of-interest statement: None of the authors have a conflict of interest to report.

Correspondence to: Yu-Hu Song, PhD, MD, Professor, Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 2009xh0899@hust.edu.cn

Telephone: +86-27-85726678 Fax: +86-27-85726057

Received: April 27, 2018
Peer-review started: April 27, 2018
First decision: June 20, 2018
Revised: July 26, 2018
Accepted: August 19, 2018
Article in press: August 20, 2018
Published online: October 6, 2018
Processing time: 154 Days and 20 Hours

Abstract

The descending duodenum is rarely involved in Schistosoma japonicum (S. japonicum) infection. Here, we report a case of acute Schistosoma infection, which presented with abdominal pain, abdominal distension and irregular fever. Tumor-like lesions were observed in the descending duodenum. Simultaneously, heterogeneity in hepatic perfusion was demonstrated by dynamic computed tomography scanning. Biopsy of the descending duodenum showed the deposition of Schistosoma eggs. Following administration of the antihelminthic drug praziquantel, the patient showed rapid clinical improvement. In conclusion, we report a patient with acute S. japonicum infection presenting as tumor-like lesions in the descending duodenum and heterogeneity of blood perfusion in liver parenchyma.

Keywords: Schistosoma japonicum; Heterogeneity; Duodenum; Tumor-like lesions; Liver

Core tip:Schistosoma japonicum (S. japonicum) is primarily found in the mesenteric veins and tends to involve the colon, rectum and liver. Here, we report a case of acute S. japonicum infection in a patient presenting with tumor-like lesions in the descending duodenum and heterogeneity of blood perfusion in liver parenchyma.