41 Colonic Schistosomiasis Masquerading as Multiple Colonic Polyps on Colonoscopy: A Rare and Challenging Clinical Encounter

Introduction/Objective Schistosomiasis, caused by Schistosoma trematodes, is a common parasitic infection in tropical and subtropical regions, affecting an estimated 200 to 300 million individuals. It includes five distinct species: Schistosoma mansoni, Schistosoma japonicum, Schistosoma mekongi, Schistosoma haematobium, and Schistosoma intercalatum. Colonic involvement in schistosomiasis, which manifests as colonic polyps—especially in non-endemic areas—is rare and presents diagnostic challenges due to its unusual presentation. Understanding the epidemiology, clinical features, diagnosis, and treatment of this parasitic infection is essential for effective disease control and prevention. Methods/Case Report A 45-year-old man presented with abdominal pain and underwent a colonoscopy, which revealed small colonic polyps that were removed via polypectomy. Microscopic examination of the polyps showed submucosal granulomas with numerous eosinophils surrounding non-polarizable ova with spines, leading to a definitive diagnosis of schistosomiasis infection. Results NA Conclusion Colonic schistosomiasis is rare, and its clinical manifestations mimic those of other pathologies, making diagnosis challenging. Clinicians must maintain a high level of suspicion, particularly when there is a relevant history of travel or exposure. An accurate diagnosis depends on endoscopic findings and histopathology, which can reveal characteristic ova and granulomas. Increased awareness is essential for prompt diagnosis, appropriate management, and the prevention of long-term complications, especially in non-endemic settings.