The Use of Ultrasonography in The Complications of Schistosoma Mansoni

Abstract

This study is a practical and descriptive study which continued for two years and was carried out in Khartoum Teaching Hospital and ultrasound department in the college of Medical Radiologic Science. It discusses the protocol of ultrasound scanning in demonstrating of the complications of schistosoma mansoni. Known cases of schistosoma mansoni (100 patients) were surveyed by ultrasound using Aloka scanner with 3.5 MHz probe. Abdominal ultrasound scanning were performed for all patients. Ultrasound was used to demonstrate clearly the complications of schistosoma mansoni such as grades of periportal fibrosis, portal hypertention, splenomegaly ascites, formation of collaterals and gall bladder wall thickening except those which were in the chest and brain. The study showed that it is possible to correlate between the grades of periportal fibrosis and liver size, portal hypertention, splenic size and gall bladder wall thickening. The ultrasound appearance of the complications could be used as guidance for changing the scanning technique. Fourty five patients (45 %) were noted to have pipe stem periportal fibrosis and fifty five patients (55%) were noted to have diffused periportal fibrosis. Twenty three patients (23%) had a mild portal hypertention, thirteen patients (13%) had a moderate portal hypertention and twenty one patients (21%) were found to have marked portal hypertention. Twenty six patients (26%) were found to have ascites while seventy four patients (74%) were found to have no ascites. On the other hand eighteen patients (18%) considered to have esophageal avarices, while eighty two patients (82%) were found to have no collaterals. Eleven patients (11%) were found to have no splenomegaly, twenty four patients (24%) had mild VII splenomegaly, twenty eight patients (28%) had moderate splenomegaly and thirty seven patients (37%) were found to have gross splenomegaly. Fourty patients (40%) were found to have thick wall gall bladder, while sixty patients (60%) were found to have normal wall. Regarding the patients of pipe stem periportal fibrosis, the study found that (86.7%) of them had a normal liver size, (75.6%) had no portal hypertention, (42.2%) of them had a mild splenomegaly and (86.7%) had no gall bladder wall thickening. Regarding the patients of diffused periportal fibrosis, the study also found that (50.9%) of them were found to have shrunken liver, (38%) had marked portal hypertention, (63.6%) were found to have gross splenomegaly and (61.8%) had thickening of the gall bladder wall. The study also found that (80.7%) of the patients with marked portal hypertention, were found to have ascites and (88.8%) of the patients for the same group, were found to have collaterals, so according to the relation between all the complications, a protocol for scanning technique using u/s has been made.