Clinical versus ultrasound examination in the evaluation of hepatosplenic schistosomiasis mansoni in endemic areas

• Main Authors: Carolina Coimbra Marinho, Izabela Voieta, Letícia Martins Azeredo, Marina Pires Nishi, Thaís Sanai Batista, Ana Carolina Figueiredo Pereira, José Carlos Serufo, Leonardo Campos de Queiroz, Raiza Ruiz-Guevara, Carlos Maurício Antunes, Aluízio Prata, José Roberto Lambertucci
• Format: Article
• Language: English
• Published: Instituto Oswaldo Cruz, Ministério da Saúde 2006-10-01
• Series: Memórias do Instituto Oswaldo Cruz.
• Subjects: schistosomiasis; ultrasound; physical examination; spleen; liver; portal hypertension
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762006000900050

The best way to appraise the size of abdominal organs remains undefined. Herein we compare the size of liver and spleen in hepatosplenic schistosomiasis using clinical and ultrasound (US) examination, and the size of the organs measured by US with their visualization below the costal margin ("palpable by US"). For this study, 411 individuals from an endemic area for schistosomiasis mansoni in Brazil have been selected. We found that palpable spleens and left liver lobes are larger than non palpable ones. Also, 23% of normal spleens measured by US were palpable on clinical examination, and 22% of spleens increased in size on US were non palpable. A total of 21% of normal spleens were "palpable by US". We also found 54% of normal sized right liver lobes palpable on clinical examination, whilst 54% of the increased livers, measured by US, were non palpable. About 76% of normal right liver lobes were "palpable by US". We conclude that the association of clinical, ultrasound and magnetic resonance imaging (MRI) examinations, in the near future, should give the investigators the necessary tools to perform a more accurate clinical diagnosis of hepatosplenic schistosomiasis mansoni.