• Schistosoma mansoni (liver fluke worm) must be considered among the possible causes of gastrointestinal disease in parts of the United States where this infestation was formerly unknown. The large shift of population from Puerto Rico, where the parasite is endemic, has brought the disease to the attention of proctologists as the cause of characteristic lesions of the mucous membrane of the rectum and sigmoid. The eggs of the parasite cause liver disease, with portal hypertension, ascites, splenomegaly, and esophageal varices, in infected children and adults coming from Puerto Rico. A precise diagnostic method is described, utilizing small specimens of rectal mucosa for identification of the eggs.
Warner BW. DIAGNOSIS OF SCHISTOSOMIASIS BY SIGMOIDOSCOPY AND RECTAL MUCOSAL BIOPSY. JAMA. 1957;163(15):1322–1325. doi:10.1001/jama.1957.02970500006002
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