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Portal congestion and thrombosis after EDS

BACKGROUND: The study compared the preoperative portal vein congestion index estimated by Doppler ultrasound and the postoperative portal vein thrombosis of patients submitted to esophagogastric devascularization and splenectomy (EDS). METHODS: 65 patients with portal hypertension due to schistosomiasis and previous gastrointestinal bleeding submitted to EDS were divided into two groups: GROUP A (28 patients without postoperative portal vein thrombosis) and GROUP B (37 patients with postoperative portal vein thrombosis). The following parameters of preoperative Doppler ultrasound of the portal vein were analyzed: diameter, area, mean blood flow velocity and blood flow, whereupon the congestion index was calculated. RESULTS: The diameter, area and blood flow of the portal vein were greater in group B (mean of 1.52 cm; 1.77 cm² and 2533.12 ml / min) than in group A (mean of 1.33 cm; 1.44 cm² and 1609.03 ml / min) with p = 0.03; 0.03 and 0.04 respectively. Difference of the congestion index was not statistically significant between the two groups (p = 0.07). CONCLUSIONS: The portal vein congestion index at the preoperative of EDS estimated by Doppler ultrasound was not predictive of portal vein thrombosis in the postoperative of patients with portal hypertension due to schistosomiasis.

Portal hypertension; Schistosomiasis; Ultrasound; Doppler; Thrombosis; Portal vein


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