Schistosomiasis: Hepatosplenic Disease and Portal Hypertensive Complications

AbstractPurpose of ReviewSchistosomiasis is an important and often neglected disease in tropical climates and is associated with significant comorbidity due to the complication of periportal fibrosis, termed hepatosplenic schistosomiasis. Clinically significant portal hypertension can develop as a complication of periportal fibrosis and is associated with life-threatening gastrointestinal bleeding due to the formation of esophagogastric varices. Unfortunately, patients with established infections can be asymptomatic and may not present for evaluation before significant clinical symptoms are identified.Recent FindingsEffective screening and prevention programs are paramount to prevent infection and the associated long-term Sequelae. The diagnosis of a chronic infection typically relies on the detection of parasite eggs in the patient ’s feces or urine. A combination of clinical examination and imaging is required for the diagnosis of hepatosplenic schistosomiasis. Periportal fibrosis, hepatosplenomegaly or clinically significant portal hypertension are most commonly identified through ultrasound-based imaging. The management o f hepatosplenic disease relies on the application of parasite-directed pharmaceuticals, with endoscopic, surgical, or interventional radiology techniques directed toward portal hypertensive complications. Endoscopic band ligation is currently one of the most popular methods used to manage esophageal varices in patients with hepatosplenic complications....
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research