Hepatosplenic morbidity in schistosomiasis japonica: Evaluation with Doppler sonography

In Southeast Asia, schistosomiasis japonica is an important cause of hepati c fibrosis and gastrointestinal hemorrhage. Reliable methods to investigate portal hypertension (PHT) clinically and epidemiologically on community le vel are lacking. Doppler sonography is an established tool for investigatin g PHT in hospital settings. In Leyte, The Philippines, 137 individuals unde rwent color Doppler sonography, stool examination, and serology for hepatit is B and C, liver cell injury and cholestasis. A total of 85% of the study population had been infected with Schistosoma japonicum. Sonographically, p eriportal liver fibrosis was seen in 25% and reticular echogenicities (netw ork pattern) in 44%. Portal blood flow was decreased or portosystemic colla terals were present in 10% (adults throughout) and correlated with periport al fibrosis, but not with network lesions. Chronic viral hepatitis was rare . Thus, hepatic lesions an frequent in adults but not in children in areas endemic for S, japonicum. Periportal liver fibrosis indicates a risk of PHT , and network pattern fibrosis apparently does not. Doppler sonography is s uitable for research under tropical field conditions.