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.
