Hepatosplenic schistosomiasis: a clinical review

Hepatosplenic schistosomiasis refers to the major complication of chronic infection with Schistosoma mansoni, S japonicum and S mekongi, schistosomal portal hypertension. Hepatosplenic schistosomiasis is usually, but not invariably, associated with enlargement of the liver and spleen, and reversible hepatosplenomegaly may occur in early infections not complicated by the development of portal hypertension. This paper broadly examines current knowledge concerning hepatosplenic schistosomiasis, emphasising clinical aspects. It draws on the author's experience in East Africa,1 and is concerned mainly with schistosomiasis mansoni. Infection with S japonicum and S mekongi, both restricted to parts of the Far East, are not specifically discussed. Clinical aspects of hepatosplenic schistosomiasis cannot be considered distinct from the epidemiology, pathology and pathogenesis of the condition, and these are briefly reviewed.