title: Surgical indication in Schistosomiasis mansoni portal hypertension: follow-up from 1985 to 2001.
abstract: 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.
authors.affiliation: Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, UFRJ, Rio de Janeiro, RJ, Brasil. onceiao@ioc.fiocruz.br
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Conceição
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Argento
authors.forename: Orlando Marques
authors.initials: OM
authors.lastname: Vieira
authors.forename: Cristina Maeda
authors.initials: CM
authors.lastname: Takiya
authors.forename: Vera Lúcia A
authors.initials: VL
authors.lastname: Chagas
mesh_terms: D000293:Adolescent; D000328:Adult; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000469:parasitology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012555:Schistosomiasis mansoni / Q000150:complications / Q000601:surgery*; D013156:Splenectomy; D013158:Splenic Diseases / Q000601:surgery; D016896:Treatment Outcome