Ultrasonography of periportal fibrosis in schistosomiasis mansoni in Brazil

Abstract

In patients with hepatosplenic schistosomiasis, characteristic thickening of the walls of the portal vein in the hilus and its central and peripheral branches is observed. In an area of high prevalence of the disease in Brazil, 424 individuals older than 5 years have been examined by abdominal ultrasonography and 146 presented fibrosis, classified as central in 31 (21%), peripheral in 56 (38%), and both central and peripheral in 59 (40%). The mean ages of the subjects in the 3 groups were 45.7, 24.1 and 31.9 years, respectively (P < 0.05). The presence of central fibrosis was associated with the presence of peripheral fibrosis (odds ratio 10.7, P < 0.000001). Splenomegaly was found in 16% and 15% of individuals with peripheral and both central and peripheral fibrosis, respectively. No subject with central but no peripheral fibrosis and splenomegaly was identified. We conclude that central fibrosis occurs among older subjects but should not be considered a criterion for advanced disease.

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

“…endoscopic and sonographic findings and variceal bleeding were compared had conflicting results: whereas in earlier studies a relationship between the sonographic grade of periportal fibrosis, the occurrence of variceal haemorrhage prior to examination and/or the grade of oesophageal varices had not been found (Homeida et al 1988;Davidson et al 1991), more recent investigations showed that the sonographic grade of periportal fibrosis is related to prior variceal haemorrhage (Richter et al 1992a;Domingues et al 1993;Abdel-Wahab et al 1993;Eltoum et al 1994;Gerspacher-Lara et al 1997).…”

Hepatosplenic schistosomiasis in field-based studies: a combined clinical and sonographic definition

“…Peripheral fibrosis was considered to be present when three peripheral portal branches with thickened walls (> 2 mm) were described; thickening of the gallbladder wall (> 5 mm) was also considered (Gerspacher-Lara et al 1997). The presence of portosystemic collaterals were annotated (Domingues et al 1993).…”

Clinical versus ultrasound examination in the evaluation of hepatosplenic schistosomiasis mansoni in endemic areas

“…Key words: schistosomiasis -ultrasound -physical examination -spleen -liver -portal hypertension Ultrasound (US) has been routinely used in the evaluation of hepatosplenic schistosomiasis mansoni for the last 20 years (Pinto-Silva et al 1994, Lambertucci et al 1996, Gesparcher-Lara et al 1997, Martins et al 1998. The use of US is justified by its low cost, and portability which made it possible to be used in field-based studies.…”