ABSTRACT
The clinical manifestation,endoscopic findings and histopathological characteristics of 162 patients with gastrointestinal schistosomiasis were retrospectively analyzed.Among 162 patients,there were 29 cases of gastric schistosomiasis and 133 cases of intestinal schistosomiasis.The main clinical manifestations included stomachache,diarrhea and mucous bloody stool.Endoscopic findings:in 29 cases of gastric schistosoniasis,18 were ulcerative type,5 inflammatory type,6 proliferative type and 7 cases combined with gastric cancer.In 133 cases of intestinal schistosomiasis,17 were acute inflammatory type,81 chronic inflammatory type,33 mixture inflammatory type and 32 combined with colorectal cancer.Forty nine cases (30.25％) were misdiagnosed for various reasons; commonly misdiagnosed as ulcerative colitis,intestinal tuberculosis,chronic gastritis,and gastrointestinal tumors.There are no specific clinical manifestations or endoscopic findings of gastrointestinal schistosomiasis; epidemiological data,endoscopy combined with multi-site multi-block biopsy may improve the diagnosis.
ABSTRACT
Gastrointestinal disease can be diagnosed by observing the lesion through endoscopic examination. The location, size, and shape of the lesion can be determined by direct observation, and the final endoscopic diagnosis is made based on the knowledge and experience of the examiner. However, such diagnosis based on direct observation and examiner's judgment can be inaccurate, suggesting the need to perform biopsy. Since most gastrointestinal disease involve lesion forming from the mucosa level, biopsy is more useful if done by endoscopy. Biopsy is especially crucial in diagnosing a case vague to determine with naked eyes, distinguishing the lesion as benign or malignant, determining the boundary of the lesion, and assessing the effectiveness of the treatment. Enough tissue should be collected in order to make an accurate diagnosis. In order to make an accurate diagnosis, one should collect the tissue as much as possible. Shifting the lesion towards the bottom of the endoscope field, changing the posture of the patient to make the lesion perpendicular, improves the accuracy of the biopsy. Cutting edge equipments such as transparent cap, side-view endoscopy, two channel endoscopy, and double bend endoscopy also enable precise biopsy. In addition, it is crucial to provide the pathologist with enough information. Using the clinical information of the patient, diagnosis made by endoscopy and that made by biopsy should be attempted to be in agreement. Biopsy is an invasive diagnosing method, so it should always be done carefully to minimize any complication.