Schistosomiasis: clinical relevance to surgeons in Australasia and diagnostic update

All surgeons working in Australasia should be prepared to encounter imported cases of schistosomiasis. The disease should be considered when typical symptoms are present, and there is evidence of skin exposure to fresh water in an endemic area. Whether or not signs of urinary or intestinal tract schistosomiasis are present, ectopic ova can involve and produce symptoms in almost any structure including the liver, the lungs, the reproductive system and the central nervous system, sometimes producing puzzling clinical abnormalities decades after primary infection. Recovery of ova from urine, stool or their detection in a biopsy confirms diagnosis but, when this is unsuccessful, immunological tests support diagnosis. Imaging techniques (e.g. ultrasonography, standard radiology, computed tomography or magnetic resonance imaging scans) may indicate and define involvement of various organs and structures. The surgeon often has an important role to play in the management of the protean complications of schistosomiasis.