Bilharzial pipe-stem portal fibrosis in Zambia

Bilharzial disease of the liver is now an established clinico-pathological entity. The entire spectrum of the disease from early involvement to classical Symmers' pipe-stem portal fibrosis (PSPF) is well documented (Fairley, 1920; Dew, 1923; Koppisch, 1943; Hashem, 1947; Deschamps, Redmond and Deleeuw, 1955; Dimmette, 1955; El-Gholomy et al., 1955; Bogliolo, 1957 ; Carter and Shaldon, 1959; Bhagwandeen, 1964). The major reports of the disease have been from hyperendemic areas of schistosomiasis mansoni, particularly from Egypt in Africa and Brazil in South America. Workers in endemic areas, especially in Africa south of the Sahara have been rather sceptical of " bilharzia] cirrhosis" as a clinico-pathological entity (Gelfand, 1950, 1962; Becker and Chatgidakis, 1961; Higginson and Steiner, 1961; Prates, 1961; Wainwright, 1961). More recent reports (Gelfand, 1967; Bhagwandeen, 1968) indicate that hepatic bilharzia] disease is not rare in endemic areas.