The bedside assessment of splenic enlargement

Barkun, Alan N.; Camus, Michel; Green, Laurence; Meagher, Tim; Coupal, Louis; Stempel, Jeannette De; Grover, Steven A.

doi:10.1016/0002-9343(91)90188-4

Cited by 46 publications

(34 citation statements)

References 19 publications

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“…At clinical examination, he was pale with a palpable liver and an enlarged spleen (Boyd III). Blood counts revealed reduction in all cell series: 3.2 x 10 6 red cells/mm 3 , hemoglobin 6.0 g/dL, 1.4 x 10 3 white cells/mm 3 , 51 x 10 3 platelets/mm 3 . Blood chemistry and coagulation were unremarkable.…”

Section: Patient and Methodsmentioning

confidence: 94%

Magnetic resonance imaging and ultrasound in hepatosplenic schistosomiasis mansoni

Lambertucci

Silva

Andrade

et al. 2004

Rev. Soc. Bras. Med. Trop.

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Section: Patient and Methodsmentioning

confidence: 94%

Magnetic resonance imaging and ultrasound in hepatosplenic schistosomiasis mansoni

Lambertucci

Silva

Andrade

et al. 2004

Rev. Soc. Bras. Med. Trop.

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“…In the last two decades some works comparing splenic palpation to more accurate means for the diagnosis of splenomegaly (scintilography and ultrasound) have been published showing limitations of abdominal palpation (Barkun et al 1991). More recently, Gerspacher-Lara et al (1998), comparing physical examination with ultrasound, concluded that splenic palpation is a poor method for the diagnosis of splenomegaly in endemic areas for schistosomiasis.…”

mentioning

confidence: 99%

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

Lambertucci

Cota

Pinto-Silva

et al. 2001

Mem. Inst. Oswaldo Cruz

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“…Liver and spleen enlargement in a person eliminating S. mansoni eggs in stool was indicative of Symmers fibrosis in both epidemiological studies and in those involving hospitalized patients. In the last two decades, studies comparing spleen palpation with more accurate methods for detecting spleen enlargement, such as ultrasound, have shown serious limitations on abdominal physical examination (Sullivan & Williams 1976, Barkun et al 1991. These studies have established that some spleens of normal size are palpable, and have confirmed that many enlarged spleens are non palpable.…”

Section: Discussionmentioning

confidence: 99%

Disagreement between ultrasound and magnetic resonance imaging in the identification of schistosomal periportal fibrosis

Silva

Pereira

Queiroz

et al. 2006

Mem. Inst. Oswaldo Cruz

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Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease, and it has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis. We describe the case of a man in whom USshowed solid evidence of schistosomal periportal fibrosis and magnetic resonance imaging revealed that periportal signal alteration corresponded to adipose tissue which entered the liver togheter with the portal vein.Key words: schistosomiasis -Schistosoma mansoni -ultrasound -magnetic resonance imaging Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease (Abdel-Latif et al. 1981, Hussain et al. 1984, Fataar et al. 1984, Cerri et al. 1984, Homeida et al. 1988a, b, Abdel-Wahab et al. 1989, PintoSilva et al. 1994, Gerspacher-Lara et al. 1998, GerspacherLara 1999, Niamey Working Group 2000, Ritcher et al. 2001. US has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis in schistosomiasis (Massoud et al. 1986, Homeida et al. 1988c, Homeida et al. 1991, DoehringSchwerdtfeger et al. 1992, Boisier et al. 1998, Frenzel et al. 1999, De Jesus et al. 2000, Cota et al. 2006. Ultrasonographic examination of subjects with hepatosplenic schistosomiasis has detected a characteristic pattern of abnormalities, quite different from the aspects observed in liver cirrhosis (Homeida et al. 1988a, Abdel-Wahab et al. 1989) and in acute schistosomiasis (Barata et al. 1999, 1997. The most important finding was echogenic thickening of the walls of the portal vein and its branches. Field studies in endemic areas have shown that the sum of total thickening of three peripheral branches of the portal vein, thickening of gallbladder wall, enlargement of the left lobe of the liver, and thickening of the portal vein in its bifurcation are the best variables for ultrasonographic diagnosis of schistosomiasis mansoni (Gerspacher-Lara 1999).Magnetic resonance imaging (MRI) has been described in four cases of hepatosplenic schistosomiasis mansoni (Patel et al. 1993, Willemsen et al. 1995, Lambertucci et al. 2002, 2004 puted tomography (CT) and MRI in the evaluation of a patient with hepatosplenic schistosomiasis mansoni. The findings of the different methods were in agreement in both studies. Periportal echogenic thickening on US, suggestive of fibrosis, and low attenuation bands about the portal vessels, which markedly enhanced with contrast CT were described. MRI demonstrated the same periportal bands that were seen on liver US and CT scans. These bands showed hiperintense signal on T2-weighted sequences, and were isointense in T1-weighted sequences, with enhancement after contrast administration. The studies of Lambertucci et al. (2002Lambertucci et al. ( , 2004 evaluated patients with advanced forms of hepatosplenic schistosom...

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The bedside assessment of splenic enlargement

Cited by 46 publications

References 19 publications

Magnetic resonance imaging and ultrasound in hepatosplenic schistosomiasis mansoni

Magnetic resonance imaging and ultrasound in hepatosplenic schistosomiasis mansoni

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

Disagreement between ultrasound and magnetic resonance imaging in the identification of schistosomal periportal fibrosis

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