Portal hypertension and hypersplenism in pregnancy secondary to chronic schistosomiasis. A case report.

In this country, Schistosoma mansoni infections are seen rarely since the distribution of schistosomes in humans is governed by the range of their molluscan hosts. The snail hosts of S. mansoni reside in fresh waters of tropical zones. A native of Brazil was seen in her second trimester of pregnancy with marked splenomegaly and hypersplenism. Thirteen years before she had been treated for schistosomiasis, and she had been well until her pregnancy. Studies were done to rule out other causes of splenomegaly and hypersplenism. Esophageal endoscopy confirmed the presence of esophageal varices. The main risk to these patients is severe, sometimes fatal gastrointestinal bleeding. In our patient this risk was compounded by marked thrombocytopenia. Splenectomy was performed, and a liver biopsy confirmed the presence of S. mansoni eggs.