Schistosoma ova found in gastrostomy site granulation tissue

Abstract

Background: Severe traumatic brain injury (TBI) occurs rarely in children. Gastrostomy tube placement is a frequently performed procedure in children and has various indications including neurologic impairment. One of the common complications of gastrostomy is granulation tissue formation resulting from chronic irritation. Case presentation: We present the case of 12-years-old Asian male patient that was referred to our hospital as a victim of road traffic accident (RTA) with polytrauma (severe traumatic brain injury, fracture left tibia & fibula). He underwent laparoscopic gastrostomy for long-term feeding. Post tube placement, granulation tissue formed and persisted in spite of multiple silver nitrate cauterization trials necessitating surgical removal. On histopathologic examination of the excised specimen, it was found to harbour schistosoma ova. Conclusion: Gastrostomy tube placement is commonly performed in pediatric cases with serious neurologic insult. Many cases of Schistosoma infestation are asymptomatic. Some cases have atypical presentation including histopathologic diagnosis. Keywords: Severe traumatic brain injury, Gastrostomy, Laparoscopic gastrostomy, Schistosoma infestation, Silver nitrate application