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Ultrasonography of gallbladder abnormalities due to schistosomiasis

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Abstract

After malaria, schistosomiasis remains the most important tropical parasitic disease in large parts of the world. Schistosomiasis has recently re-emerged in Southern Europe. Intestinal schistosomiasis is caused by most Schistosoma (S.) spp. pathogenic to humans and leads to chronic inflammation and fibrosis of the colon as well as to liver fibrosis. Gallbladder abnormalities usually occur in patients with advanced hepatic portal fibrosis due to Schistosoma mansoni infection. Occasionally, gallbladder abnormalities have been seen also in children and occurring without associated overt liver abnormalities.

The specific S. mansoni-induced gallbladder abnormalities detectable by ultrasound include typical hyperechogenic wall thickening with external gallbladder wall protuberances. The luminal wall surface is smooth. The condition is usually clinically silent although some cases of symptomatic cholecystitis have been described. The ultrasonographic Murphy response is negative. Gallbladder contractility is impaired but sludge and calculi occur rarely. Contrary to other trematodes such as liver flukes, S. mansoni does not obstruct the biliary tract. Advanced gallbladder fibrosis is unlikely to reverse after therapy.

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Authors and Affiliations

  1. Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

    Joachim Richter, Martha C. Holtfreter, Robert Akpata, Tarik El-Scheich, Matthias Breuer & Gerald Kircheis

  2. Department of Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Créteil, France

    Daniel Azoulay

  3. INSERM, UMR-955, Créteil, France

    Daniel Azoulay

  4. Medical Clinic 2, Caritas Hospital Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg, Germany

    Yi Dong & Christoph F. Dietrich

  5. Saint Jean de Dieu Hospital, Tanguiéta, Benin

    Robert Akpata

  6. Department of Pathology, Henri Mondor Hospital, AP-HP, Créteil, France

    Julien Calderaro

  7. Swiss Tropical and Public Health Institute, Basel, Switzerland

    Andreas Neumayr & Christoph Hatz

  8. Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland

    Christoph Hatz

  9. INSA, National Institute of Health Dr. Ricardo Jorge and IPATIMUP/I3S, Institute of Pathology and Molecular Immunology/Instituto de Investigação e Inovação da Universidade do Porto, Porto, Portugal

    Monica C. Botelho

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  1. Joachim Richter
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Richter, J., Azoulay, D., Dong, Y. et al. Ultrasonography of gallbladder abnormalities due to schistosomiasis. Parasitol Res 115, 2917–2924 (2016). https://doi.org/10.1007/s00436-016-5116-0

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