Abstract
We experienced a case of Schistosomiasis, diagnosis being confirmed by aimed liver biopsy under visual control in conjunction with peritoneoscopy. A 59 year-old male with general malaise and loss of appetite more than 5 years prior to the first visit to a doctor who transfered him to our clinic on May 24, 1984 because of mild elevation of γ-GTP activity and abnormal findings suggestive of hepatocellular carcinoma in echogram. He had been in Shanghai, China and Kurume, Fukuoka prefecture, where Schistosomiasis had been prevalent. Liver was 3fb palpable on the right midclavicular line, of which surface being smooth. No other abnormal findings was found in physical examination. Laboratory data on admission were all within normal limits. Echogram demonstrated net work pattern. Abdominal CT showed spotted high density pattern. Peritoneoscopic examination of the liver revealed that liver surface was slightly uneven (Code No. 320 according to Shimada's code number system), and yellowish-whitish egg nodules were scattered on the liver surface. Egg nodules were located in portal area, hepatic parenchymal region, and also in the whitish area. Schistosomal ova with mild inflamatory cell infiltration and fibrosis were disclosed by histological examination of the specimen obtained by aimed biopsy of the liver. It is concluded that peritoneoscopic observation is useful for diagnosis of Schistosomiasis and use of magnified lens and aimed biopsy are indispensable diagnotic procedures.
