Characterization of portal hypertension in hepatosplenic schistosoma mansoni patients using B-mode ultrasound

Abstract

This study was designed to characterize portal hypertension (PH) by assessing cirrhosis, estimating portal vein (PV) width and spleen size, identifying ascites and deciding abnormal collateral routes in hepatosplenic Schistosoma mansoni patients using brightness mode (Bmode) ultrasound (US). A total of 209 adult patients with hepatosplenic Schistosoma mansoni were prospectively recruited from the Gezira state in central Sudan between February 2016 and May 2019. The sonographic features observed include the overall assessment of liver size, PV diameter, gallbladder (GB) wall thickness, splenic size, the lack of or reduced respiratory variations of the splenic vein (SV), collateral circulation and the presence of ascites. The results revealed that a majority of patients were affected with PH due to schistosomiasis infection (94.7%), liver cirrhosis (3.8%) and viral cirrhosis (1.4%). The measures of PV diameter and the lack of or reduced respiratory variations of SV in patients affected with schistosomiasis were statistically significant when compared with the mean value obtained from the healthy adult participants in the control group (p < 0.05). Furthermore, over half of the examined patients presented with portosystemic collaterals. In conclusion, the US findings were highly specific and sufficient to diagnose PH due to schistosomiasis infection.