Skip to main content

Sonographic prediction of variceal bleeding in patients with liver fibrosis due to Schistosoma mansoni

Buy Article:

The full text article is temporarily unavailable.

We apologise for the inconvenience. Please try again later.

Summary Several studies have shown that the characteristic hepatic abnormalities induced by Schistosoma mansoni detectable by ultrasound correlate with the degree of oesophageal varices. So far the value of ultrasound for predicting variceal haemorrhage has not been assessed. Fifty Brazilian patients with schistosomal periportal fibrosis from Alagoas State, 18 of whom had already bled from oesophageal varices, were enrolled in a combined cross-sectional and longitudinal study and investigated clinically, by endoscopy and by ultrasound. Twenty-seven of the patients were monitored until another bleeding episode, death or for a minimum of 28 months. Eight of these patients could be followed up for a further three years. A sonographic score, which accounts for the degree of echogenic periportal thickening and of portal vein dilatation, was calculated for all patients. A highly significant correlation (P < 0.0001) existed between the sonographic score and the occurrence of previous variceal haemorrhage, paralleled by a similar correlation between the sonographic score and the degree of oesophageal varices (P < 0.001). In the 27 patients monitored longitudinally, the sonographic score indicated the risk of future variceal bleeding (P < 0.0001). The sonographic score reliably predicts the risk of variceal bleeding in individual patients with periportal fibrosis. Hence, the application of endoscopy, if available at all in endemic areas, may be restricted to the patients at risk of future variceal bleeding, as determined by ultrasound. Since portable devices can be carried even to remote areas, the application of the proposed score in community surveys could provide a new means for the identification of high-risk patients in S. mansoni-infected populations.
No References
No Citations
No Supplementary Data
No Data/Media
No Metrics

Keywords: S. mansoni; hepatic abnormalities; oesophageal varices; ultrasound

Document Type: Research Article

Affiliations: 1: Institute of Tropical Medicine, Berlin, Germany 2: Department of Parasitology, School of Medical Sciences, Maceió, Alagoas, Brazil 3: National Health Foundation, Alagoas, Maceió, Brazil 4: Department of Medical Statistics, Free University, Berlin, Germany 5: Laboratory of Parasitology, University of Leiden, The Netherlands 6: Faculty of Medicine, Free University Berlin, Berlin, Germany

Publication date: 1998-09-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more