Ultrasound appearance of preclinical Oesophagostomum bifurcum induced colonic pathology

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Abstract
Background—Oesophagostomum bifurcum is a parasitic helminth endemic in southern West Africa, infecting an estimated 250 000 people.1 2 It develops within the colonic wall resulting in symptomatic granulomatous lesions detectable by ultrasound,3 and accounts for 1% of major surgeries within the endemic area of northern Ghana, presenting with peritonitis or bowel obstruction.4 These echo free lesions within the abdominal or colonic wall of 50 mm in diameter, on average, have a well defined ovoid shape and are surrounded by a poorly reflective wall. They protrude into the colonic lumen and show posterior wall enhancement. However, asymptomatic abdominal lesions of smaller but similar appearance are commonly observed on ultrasound in healthy individuals from villages within this area.5 The lesions are suspected to have O bifurcum aetiology. Case reports —We observed two patients from northern Ghana presenting with right lower quadrant …

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