IMPROVEMENT OF SCHISTOSOMAL PORTAL HYPERTENSIVE COLOPATHY AFTER SURGICAL TREATMENT

Arquivos de Gastroenterologia

Maria Angelina Carvalho Miranda¹  Álvaro Antônio Bandeira Ferraz¹  Ana Lúcia Coutinho Domingues¹  Renata Carvalho Miranda Chaves¹  Norma JucÁ¹  Diógenes Luiz Da Mota¹ 

关键词: Hypertension;    portal;    Schistosomiasis mansoni;    Colonic diseases;    Microvascular descompression surgery;    Hipertensão portal;    Esquistossomose mansoni;    Doenças do cólon;    Cirurgia de descompressão micro vascular;   

DOI  :  10.1590/S0004-28032013000200026

来源: SciELO

【 摘 要 】

Context Data on vascular alterations in patients with hepatosplenic schistosomiasis and portal hypertensive colopathy and changes in these after surgery to decrease portal hypertension are limited. Objective The purpose of this study was to analyse the alterations of portal hypertensive colopathy previously and 6-12 months after splenectomy and gastric devascularization. Methods Twelve patients with hepatosplenic schistosomiasis who also had upper gastrointestinal bleeding were studied prospectively. Their endoscopic findings before and 6-12 months after the surgery were analysed. In addition, mucosal biopsies from ascending colon, sigmoid colon and rectum at these time points were subjected to histological and histomorphometric assessment. It was used a control group due to lack of normal pattern of the histomorphometric measures of vessels in individuals without portal hypertension. The critical level of significance adopted in all tests was of a maximum probability error of 5%. Results Surgery did not lead to significant improvement in histological and endoscopic findings. However, on histomorphometry, there was a significant decrease in the area, diameter and thickness of the vessels in mucosa at all colonic sites. Conclusion Surgery for decompression of schistosomal portal hypertension has a beneficial effect on the associated colopathy, being best indicated in patients with gastrointestinal bleeding and esophageal varices.

【 授权许可】

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