Abstract

PERIPORTAL FIBROSIS IN SCHISTOSOMIASIS: ULTRASOUND ASSESSMENT AND CORRELATION WITH GASTROINTESTINAL BLEEDING

Rafaralahivoavy Tojo Rémi*, Rakotovao Mamisoa Anicet, Razafindrabekoto Lova Dany Ella, Ranoharison Dina Hasina, Razafimahefa hélio Soloniaina, Rakotoarivelo Rivo Andry and Ahmad Ahmad

Abstract

Background: Schistosomiais is a public health issue. A standardization of ultrasound examination by scores has been established by the WHO during hepato-splenic schistosomiasis. Our aims were to evaluate periportal fibrosis according to the WHO protocol and to look for a correlation between the different scores and the gastrointestinal bleeding. Materials and Methods: A descriptive prospective study was carried out at the two university hospitals in Fianarantsoa (Tambohobe and Andrainjato) from March to June 2019. The parameters we analyzed were age, profession, gatrointestinal bleeding, and the 3 ultrasound scores. Results: Twenty two patients were enrolled. The image pattern (IP score) D was seen in majority at 31.38%, the portal branch thickening score (PT score) was 8 in 59.09% and the portal hypertension score (PH score) was 0 in majority but closely followed by the scores of 10 and 13. The combined classification of the 3 scores revealed advanced periportal fibrosis with portal hypertension in 77.72%. Advanced image patterns and portal hypertension score were correlated with the occurence of gastrointestinal bleeding. Conclusion: Our patients were at an advanced periportal fibrosis. The image pattern ≥ D and the HTP score ≥ 4 were correlated with the possibility of gastrointestinal bleeding.

Keywords: Gastrointestinal bleeding, periportal fibrosis, schistosomiasis, ultrasound.