Organ involvement in hepato-intestinal schistosomiasis.

The endoscopic, radiological and histological findings in several of our patients with Schistosoma mansoni infection are described. Seventy-two patients with hepatosplenic schistosomiasis. Endoscopic sclerotherapy was effective in 45 patients with bleeding varices. Ultrasound of the liver was suggestive of periportal fibrosis in 48 of these 72 patients, in 30 of whom liver biopsy demonstrated a Schistosoma granuloma or periportal fibrosis. Gastroscopy revealed congestion, erosions or ulcerations in the stomach in 40 of these patients and in the duodenum in 23 patients. Schistosoma ova and inflammatory changes were seen in endoscopic biopsies from the stomach in three out of twelve and five out of eight duodenal biopsies. The colonoscopic findings were suggestive of schistosomiasis in 98 out of 216 patients with colonic schistosomiasis. Eight patients had schistosomal polyps and one had colonic calcifications. Schistosoma ova were seen in surgical specimens from patients presenting with an acute abdomen due to appendicitis in six, cholecystitis in three and mesenteric vein thrombosis in three. In one of the latter the mesenteric angiogram showed an internal mesenteric vein blocked by ova.