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Bilharzial portal hypertension.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1983
Summary
Schistosomiasis, a global health issue, is increasingly seen in North America. Early intervention for schistosomiasis-related portal hypertension in immigrants can prevent severe complications like esophageal varices.
Area of Science:
- Tropical Medicine
- Hepatology
- Gastroenterology
Background:
- Schistosomiasis is a significant global health concern.
- Increasing immigration from endemic regions leads to more cases in North America.
- Henry Ford Hospital observed a rise from 2 to 43 cases of active schistosomiasis post-1970.
Purpose of the Study:
- To analyze the outcomes of treating portal hypertension secondary to schistosomiasis.
- To evaluate the efficacy of portasystemic shunts in managing esophageal variceal hemorrhage in these patients.
Main Methods:
- Retrospective review of 45 patients with active schistosomiasis admitted before and after 1970.
- Analysis of patients who underwent portasystemic shunts for esophageal variceal hemorrhage.
- Assessment of operative mortality, late mortality, and encephalopathy.
Main Results:
- Six of 45 patients required seven portasystemic shunts for bleeding esophageal varices.
- No operative deaths were recorded.
- Average follow-up of 6.6 years showed no late deaths and minimal encephalopathy.
Conclusions:
- Portasystemic shunting is effective in managing bilharzial portal hypertension and its complications.
- Patients typically present with well-preserved liver function, contributing to favorable outcomes.
- Bilharzial portal hypertension should be suspected in immigrants with bleeding esophageal varices from endemic areas.