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Bilharzial Portal Hypertension
Farouck N. Obeid, MD;
Roger F. Smith, MD;
Joseph P. Elliott, Jr, MD;
Daniel J. Reddy, MD;
John H. Hageman, MD
Arch Surg. 1983;118(6):702-708.
Abstract
Schistosomiasis is a major world health problem that is being encountered more frequently in North America as the immigration patterns from endemic areas change. At Henry Ford Hospital in Detroit, only two admissions for active schistosomiasis were recorded before 1970, but since then there have been 43 such cases. Of these 45 patients, six required seven portasystemic shunts, primarily to treat the complication of esophageal variceal hemorrhage, which is associated with portal hypertension secondary to presinusoidal hepatic fibrosis. No operative deaths occurred, and follow-up averaging 6.6 years revealed no late deaths and minimal encephalopathy. These excellent results are attributed to successful portal decompression and the well-preserved liver function that is typical of these patients. Bilharzial portal hypertension should be suspected in immigrants from endemic areas who have bleeding esophageal varices.
(Arch Surg 1983;118:702-708)
Author Affiliations
From the Department of Surgery, Henry Ford Hospital, Detroit.
Footnotes
Accepted for publication Jan 3, 1983.
Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 17, 1982.
Reprint requests to Department of Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202 (Dr Smith).
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