Ultrasonography in schistosomiasis

Aim: Schistosomiasis (Bilharzia, Bilharziasis) is one of the most prevalent tropical diseases, with an increasing number of cases being imported into Europe. Sonography is among the most valuable diagnostic tools for schistos omiasis-related organ lesions. This review outlines typical findings and th eir pathophysiological context. Method and Results: Bilharziasis of the uri nary tract, usually due to Schistosoma (S.) haematobium, leads to diffuse o r localized wall thickening of the bladder and the distal ureter with typic al sonographic features. Upper urinary tract obstruction and rarely - bladd er carcinoma may complicate the course and can also be detected sonographic ally. The other species (S. mansoni, S. japonicum, S. mekongi, S. intercala tum) primarily cause (entero-) colitis; the Value of sonography in this con dition is yet undefined. In later stages, fibrotic liver involvement with p ortal hypertension may develop (hepatosplenic schistosomiasis), leading to typical ultrasound features which are nearly pathognomonic under endemic co nditions: severe periportal echogenicity with S. mansoni, and a peculiar,,n etwork pattern" of echogenic septa with S. japonicum. Sonographic indicator s of portal hypertension may be identified and graded. Conclusion: In endem ic areas in the tropics, sonography with simple portable machines offers a unique opportunity to investigate morbidity on the community level non-inva sively in large field surveys; it has thus become an important tool of clin ical and epidemiological research.