[Portal vein thrombosis after esophagogastric devascularization and splenectomy in schistosomal portal hypertension patients: what's the real importance?].
BACKGROUND
Portal vein thrombosis is the most frequent complication after esophagogastric devascularization and splenectomy for hepatosplenic schistosomosis.


OBJECTIVE
To evaluate portal vein thrombosis in 155 patients with schistosomal portal hypertension submitted to esophagogastric devascularization and splenectomy.


METHODS
We retrospectively analyzed not only the incidence and predictive factors of this complication, but also clinical, laboratorial, endoscopic and Doppler sonography outcome of these patients.


RESULTS
Postoperative portal thrombosis was observed in 52.3% of the patients (partial in 45.8% and total in 6.5%). Postoperative diarrhea was more frequent in patients with portal vein thrombosis. Fever was a frequent postoperative symptom (70%) but occurred in a higher percentage when total portal vein thrombosis was present (100%). Superior mesenteric vein thrombosis occurred in four patients (2.6%) and was associated with total thrombosis of the portal vein. There was no statistical difference between patients with and without portal vein thrombosis according to clinical and endoscopic parameters during late follow-up. It was not possible to identify any predictive factor for the occurrence of this complication.


CONCLUSIONS
Portal vein thrombosis is an early and frequent event after esophagogastric devascularization and splenectomy, usually partial with benign outcome and low morbidity. Total portal vein thrombosis is more frequently associated with a high morbidity complication, the superior mesenteric vein thrombosis. Long-term survival was not influenced by either partial or total portal thrombosis.
Makdissi
Fábio Ferrari
FF
Departamento de Gastroenterologia - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP . ffmakdissi@yahoo.com.br
Herman
Paulo
P
Machado
Marcel Autran C
MA
Pugliese
Vincenzo
V
D'Albuquerque
Luiz Augusto Carneiro
LA
Saad
William A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003967:Diarrhea / Q000175:diagnosis / Q000453:epidemiology; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006975:Hypertension, Portal / Q000469:parasitology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012552:Schistosomiasis / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult