Radiographic evaluation of patients with schistosomiasis

Plain films of the abdomen in advanced states of schistosomiasis reveal massive splenomegaly without evidence of splenic calcification. The liver may be enlarged in the early stages but ultimately decreases and becomes small. Ascites is evident in far advanced disease. Chest films are negative in the early stages, but in advanced disease, dilated pulmonary arteries, right ventricular enlargement, and dilatation of the azygous vein may be recognized. Granulomata are seen as multiple small rounded densities scattered throughout both lung fields. The routine barium swallow will reveal unsuspected esophageal varices. Nine patients were studied preoperatively by panhepatic angiography and 14 post-operatively following splenorenal shunt. Thrombosis of the shunt and hepatic encephalopathy were common postoperative complications.