Splenectomy and vasoligation for patients with haematemesis secondary to bilharzial hepatic fibrosis

One hundred and thirteen patients with haematemesis secondary to bilharzial hepatic fibrosis had splenectomy and vasoligation. There were 6 deaths in the immediate and 28 in the late postoperative period. The commonest cause of death was recurrent haematemesis followed by hepatic failure. Transient jaundice, ascites and infection were common in the postoperative period. The operation improved the cellular elements of the blood but the 20 per cent incidence of recurrent bleeding is unacceptable.