Comparação do exame clínico e da avaliação ultra-sonográfica qualitativa (palpação pelo Ultra-som) com a medida do fígado e do baço no diagnóstico da Esquistossomose Mansônica

Abstract

The best way to appraise the size of abdominal organs remains undefined. Herein we compare the size of liver and spleen in hepatosplenic schistosomiasis using clinical and ultrasound(US) examination, and the size of the organs measured by US with their visualization below the costal margin (palpable by US). For this study, 411 individuals from an area endemic for schistosomiasis mansoni in Brazil have been selected and 29 were excluded from the analysis. We found that palpable spleens and left liver lobes are larger than non palpable ones. Also, 23% of normal spleens measured by US were palpable on clinical examination, and 23% of spleens increased in size on US were non palpable. 21% of normal spleens were palpable by US. We also found 54% of normal sized right liver lobes palpable on clinicalexamination, whilst 54% of the increased livers, measured by US, were non palpable. 76% of normal right liver lobes were palpable by US. We conclude that the association of clinical, ultrasound and magnetic resonance imaging (MRI) examinations, in the near future, shouldgive the investigators the necessary tools to perform a more accurate clinical diagnosis of hepatosplenic schistosomiasis mansoni.