title: Trashepatic left gastric vein embolization in the treatment of recurrent hemorrhaging in patients with schistosomiasis previously submitted to non-derivative surgery.
abstract: BACKGROUND
  Non-derivative surgical techniques are the treatment of choice for the control of upper digestive tract hemorrhages after schistosomotic portal hypertension. However, recurrent hemorrhaging due to gastroesophagic varices is frequent.
  
  
  OBJECTIVE
  To evaluate the outcome of treatment based on embolization of the left gastric vein to control the reoccurrence of hemorrhages caused by gastroesophagic varices in patients with schistosomiasis previously submitted to non-derivative surgery.
  
  
  METHODS
  Rates of reoccurrence of hemorrhages and the qualitative and quantitative reduction of gastroesophagic varices in patients undergoing transhepatic embolization of the left gastric vein between December 1999 and January 2009 were studied based on medical charts and follow-up reports.
  
  
  RESULTS
  Seven patients with a mean age of 39.3 years underwent percutaneous transhepatic embolization of the left gastric vein. The mean time between azigoportal disconnections employed in combination with splenectomy and the percutaneous approach was 8.4 ± 7.3 years, and the number of episodes of digestive hemorrhaging ranged from 1 to 7 years. No episodes of reoccurrence of hemorrhaging were found during a follow-up period which ranged from 6 months to 7 years. Endoscopic postembolization studies revealed reductions in gastroesophagic varices in all patients compared to preembolization endoscopy.
  
  
  CONCLUSIONS
  Percutaneous transhepatic embolization of the left gastric vein in patients with schistosomiasis previously submitted to surgery resulted in a decrease in gastroesophagic varices and was shown to be effective in controlling hemorrhage reoccurrence.
authors: Vale do São Francisco Federal University, Petrolina, PE, Brazil. paulosaad@yahoo.com.br
authors: Paulo Fernandes
authors: PF
authors: Saad
authors: Alvaro
authors: A
authors: Razuk
authors: Gustavo José Politzer
authors: GJ
authors: Telles
authors: Jong Hun
authors: JH
authors: Park
authors: Fernando Pinho
authors: FP
authors: Esteves
authors: Roberto Augusto
authors: RA
authors: Caffaro
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000601:surgery / Q000628:therapy*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000469:parasitology; D012008:Recurrence; D012189:Retrospective Studies; D012555:Schistosomiasis mansoni / Q000150:complications*; D013270:Stomach / Q000098:blood supply; D016896:Treatment Outcome; D014680:Veins