Hepatosplenic schistosomiasis is a complex clinical condition caused by the complications of chronic infection with species that cause intestinal schistosomiasis. Hepatosplenic schistosomiasis derives from the fibrotic reaction stimulated around parasite eggs that are transported by the mesenteric circulation to the liver, causing periportal fibrosis. Portal hypertension and variceal gastrointestinal bleeding are major complications of hepatosplenic schistosomiasis. The clinical management of hepatosplenic schistosomiasis is not standardised and a parameter that could guide clinical decision making has not yet been identified. Transjugular intrahepatic portosystemic shunt (TIPS) appears promising for use in hepatosplenic schistosomiasis but is still reported in very few patients. In this Grand Round, we report one patient with hepatosplenic schistosomiasis treated with TIPS, which resulted in regression of oesophageal varices but had to be followed by splenectomy due to persisting severe splenomegaly and thrombocytopenia. We summarise the main challenges in the clinical management of this patient with hepatosplenic schistosomiasis, highlight results of a scoping review of the literature, and evaluate the use of of TIPS in patients with early hepatosplenic schistosomiasis, to improve the prognosis.

中文翻译：

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经颈静脉肝内门体分流术并发脾切除治疗复杂性肝脾血吸虫病一例报告并文献复习


肝脾血吸虫病是一种复杂的临床病症，由引起肠血吸虫病的物种慢性感染的并发症引起。肝脾血吸虫病源自寄生虫卵周围刺激的纤维化反应，寄生虫卵通过肠系膜循环转运至肝脏，导致门静脉周围纤维化。门脉高压和静脉曲张消化道出血是肝脾血吸虫病的主要并发症。肝脾血吸虫病的临床治疗尚未标准化，并且尚未确定可以指导临床决策的参数。经颈静脉肝内门体分流术（TIPS）似乎有望用于治疗肝脾血吸虫病，但仍有极少数患者报道。在本次大回合中，我们报告了一名肝脾血吸虫病患者接受 TIPS 治疗，食管静脉曲张得到消退，但由于持续严重的脾肿大和血小板减少，不得不随后进行脾切除术。我们总结了该肝脾血吸虫病患者临床治疗中的主要挑战，重点介绍了文献范围界定的结果，并评估了 TIPS 在早期肝脾血吸虫病患者中的应用，以改善预后。