{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:36:46Z","timestamp":1759333006569},"reference-count":79,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[1991,3,1]],"date-time":"1991-03-01T00:00:00Z","timestamp":667785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1991,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Mansonic schistosomiasis is an endemic disease in Brazil, with an estimated 10\u201312\u00a0million people infested. Among its clinical manifestations, the hepatosplenic form causes portal hypertension which, in turn, brings about severe digestive hemorrhage, the most serious complication of the disease. Normally, the patients are young, and have hepatosplenomegaly, hypersplenism without clinical manifestations, and slightly reduced hepatic function. The angiographic findings are characteristic, differing from those of hepatic cirrhosis<\/jats:bold>.<\/jats:p><jats:p><jats:bold>In Brazil, the definitive treatment for gastrointestinal hemorrhage is surgery, which should be done under elective conditions whenever possible. During a short period of time, known as the \u201crisk period\u201d (the time between the hemorrhagic episode and the surgery), propranolol has been used to prevent further bleeding. Surgical treatment is indicated only after the first episode, and never on a prophylactic basis<\/jats:bold>.<\/jats:p><jats:p><jats:bold>In 1977, a prospective, randomized trial was begun in order to assess the delayed results of the 3 surgical operations most widely used in this country. The study was interrupted after 94 patients had been operated on due to the high incidence of encephalopathy in the group who underwent classical splenorenal shunt. After a follow\u2010up of at least 60\u00a0months and, at most, 130\u00a0months, the results showed that classical splenorenal shunt caused encephalopathy in 39.3% of the cases and distal splenorenal shunt in 14.8%. None of those submitted to esophagogastric devascularization with splenectomy developed encephalopathy. The 3 procedures showed similar rates of hemorrhagic recurrence<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01659051","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T12:56:40Z","timestamp":1115557000000},"page":"176-187","source":"Crossref","is-referenced-by-count":31,"title":["Portal hypertension in mansonic schistosomiasis"],"prefix":"10.1002","volume":"15","author":[{"given":"Silvano","family":"Raia","sequence":"first","affiliation":[{"name":"Liver Unit (LIM\/37) Faculdade de Medicina da Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Mies","sequence":"additional","affiliation":[{"name":"Liver Unit (LIM\/37) Faculdade de Medicina da Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Fernando","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Liver Unit (LIM\/37) Faculdade de Medicina da Universidade de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1991,3]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1982.31.977"},{"key":"e_1_2_1_3_1","first-page":"584","article-title":"Etude epidemiologi que des foyers de bilharziose \u00e0 S. intercalatum d'Es\u00e9ka et d'Ed\u00e9a (lameroum). 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