Published online Oct 6, 2018. doi: 10.12998/wjcc.v6.i11.472
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
A 47-year-old male farmer presented with persistent abdominal pain, abdominal distension and irregular low fever.
The diagnosis of parasitic disease was made by serological test or histological examinations.
Differential diagnosis with malignant lesions due to the thickening and the destruction of the descending duodenal wall.
Serological tests for anti-Schistosoma antibody (ELISA) were positive.
Dynamic abdominal computed tomography (CT) scanning showed heterogeneous hypointensity in the liver, thickening of the descending duodenal wall, swollen mesentery around the arteries, and ascites.
Pathologic examination of the descending duodenum showed the deposition of Schistosoma eggs and infiltration of eosinophils.
The patient received the antihelminthic drug praziquantel.
The infection of Schistosoma japonicum (S. japonicum) is primarily found in the mesenteric veins and tends to involve the colon, rectum and liver, and occasionally the duodenum.
S. japonicum infection should be considered when patients have tumor-like lesions in the duodenum or hepatic heterogeneous hypointensity on dynamic CT.