title: Ultrasonography of gallbladder abnormalities due to schistosomiasis.
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.
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. Joachim.Richter@med.uni-duesseldorf.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Richter
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Créteil, France.|INSERM, UMR-955, Créteil, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
authors.affiliation: Medical Clinic 2, Caritas Hospital Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg, Germany.
authors.forename: Yi
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Martha C
authors.initials: MC
authors.lastname: Holtfreter
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.|Saint Jean de Dieu Hospital, Tanguiéta, Benin.
authors.forename: Robert
authors.initials: R
authors.lastname: Akpata
authors.affiliation: Department of Pathology, Henri Mondor Hospital, AP-HP, Créteil, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Calderaro
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Tarik
authors.initials: T
authors.lastname: El-Scheich
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Breuer
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Neumayr
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.|Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.affiliation: Tropical Medicine Unit, Department for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Kircheis
authors.affiliation: 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.
authors.forename: Monica C
authors.initials: MC
authors.lastname: Botelho
authors.affiliation: Medical Clinic 2, Caritas Hospital Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg, Germany.
authors.forename: Christoph F
authors.initials: CF
authors.lastname: Dietrich
mesh_terms: D000818:Animals; D001659:Biliary Tract / Q000473:pathology; D005355:Fibrosis / Q000469:parasitology; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D012550:Schistosoma mansoni; D012555:Schistosomiasis mansoni / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
keywords: Cholecystitis; Cholecystolithiasis; Fibrosis; Gallbladder disease; Hepatosplenic schistosomiasis; Imaging; Portal liver fibrosis; Schistosoma haematobium; Schistosoma japonicum; Schistosoma mansoni; Schistosoma sp; Schistosomiasis; Ultrasonography