Hepatic Schistosomiasis

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ICD10 CODE: B65.1

Most common cause of liver disease among communities where Schistosoma mansoni is endemic

Cause

• Inflammatory and fibrotic reaction to eggs laid by Schistosoma parasites and transported to the liver through the veins from the intestine

Clinical features

• Upper gastrointestinal bleeding due to varices or portal hypertensive gastropathy
• Splenomegaly and ruptured spleen
• Thrombocytopenia
• Portal vein thrombosis
• Bloody diarrhoea, anaemia and stunting

Investigations

• Liver ultrasound features: periportal fibrosis patterns and portal vein thickening as described by World Health Organization Niamey ultrasound protocol
• Screen for varices with endoscopy

Management

TREATMENT	LOC
Refer to a specialist Praziquantel 40 mg/kg single dose if schistosoma eggs are detected Correct anaemia as appropriate Surveillance for oesophageal varices with endoscopy Primary and secondary prevention of bleeding oesophageal varices with propranolol, endoscopic band ligation Treat acute upper gastrointestinal bleeding	HC4 HC4   RR