Surgical indication in Schistosomiasis mansoni portal hypertension: follow-up from 1985 to 2001

Memórias do Instituto Oswaldo Cruz

Maria José Conceição²  Carlos Alberto Argento²  Orlando Marques Vieira¹  Cristina Maeda Takiya¹  Vera Lúcia A Chagas¹ 

[1] ,UFRJ Hospital Universitário Clementino Fraga Filho Serviço de Doenças Infecciosas e Parasitárias

关键词: schistosomiasis mansoni;    portal hypertension;    surgical indication;    evolution;    esophageal varices;   

DOI  :  10.1590/S0074-02762002000900031

来源: SciELO

【 摘 要 】

The study had the objective to evaluate the benefits of surgical indication for portal hypertension in schistosomiasis patients followed from 1985 to 2001. Schistosoma mansoni eggs were confirmed by at least six stool examinations or rectal biopsy. Clinical examination, abdominal ultrasonography, and digestive endoscopy confirmed the diagnosis of esophageal varices. A hundred and two patients, 61.3% male (14-53 years old) were studied. Digestive hemorrhage, hypersplenism, left hypochondrial pain, abdominal discomfort, and hypogonadism were, in a decreasing order, the major signs and symptoms determining surgical indication. Among the surgical techniques employed, either splenectomy associated to splenorenal anastomosis or azigoportal desvascularization, esophageal gastric descompression and esophageal sclerosis were used. Follow-up of patients revealed that, independent on the technique utilized, a 9.9% of death occurred, caused mainly by digestive hemorrhage due to the persistence of post-treatment varices. The authors emphasize the benefits of elective surgical indication allowing a normal active life.

【 授权许可】

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