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Schistosomal portal hypertension. Assessment of portal bood flow before and after surgical treatment

BACKGROUND: Assessment of the portal blood flow in hepatoesplenic schistosomosis and the late effect of surgical treatment on portal hemodynamics. METHOD: Were studied 64 patients by duplex scan: group I (patients with schistosomal portal hypertension); group II (patients who underwent esophagogastric devascularization and splenectomy); group III (patients who underwent distal splenorenal shunt). RESULTS: Portal vein blood flow was the highest in group I (1954.46 ± 693.73 ml/min) and the lowest in group III (639.55 ± 285.86 ml/min) which correlated with follow-up time (r=-0.67, p=0.0005). Group II portal flow (1097.18 ± 342.12 ml/min) was similar to control. The same changes were seen in portal vein diameter in groups I, II, III (cm): 1.46 ± 0.23, 1.12 ± 0.22, 0.93 ± 0.20, respectively. CONCLUSIONS: Our data suggest that: 1) there is portal overflow in the physiopathology of schistosomal portal hypertension; 2) surgical treatment has interfered in hemodynamic reducing portal venous blood flow; 3) portal venous blood flow reduction correlated with follow-up time in group III but not in group II.

Liver; Portal vein; Schistosomosis; Portal hypertension; Ultrasound; Doppler


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