{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T22:44:51Z","timestamp":1648766691262},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p>RACIONAL: A anastomose esplenorrenal distal (opera\u00e7\u00e3o de Warren) tem sido indicada para tratamento do sangramento digestivo provocado pelas varizes esof\u00e1gicas pois, idealmente, reduziria a press\u00e3o venosa no territ\u00f3rio cardiotuberosit\u00e1rio sem alterar o fluxo mesent\u00e9rico-portal. Entretanto, as mudan\u00e7as que esta opera\u00e7\u00e3o provoca no territ\u00f3rio espl\u00eanico n\u00e3o foram totalmente esclarecidas. OBJETIVO: Avaliar altera\u00e7\u00f5es morfol\u00f3gicas e hemodin\u00e2micas tardias no territ\u00f3rio espl\u00eanico decorrentes da anastomose esplenorrenal distal, em pacientes com hipertens\u00e3o portal por esquistossomose mans\u00f4nica hepatoespl\u00eanica complicada com hemorragia pelas varizes esof\u00e1gicas. M\u00c9TODO: Estudo, mediante ultra-som-Doppler, da regi\u00e3o espl\u00eanica de 52 pacientes com hipertens\u00e3o portal por esquistossomose hepatoespl\u00eanica divididos em dois grupos: 40 n\u00e3o-operados e 12 com anastomose esplenorrenal distal. Neles foram comparados: a) par\u00e2metros morfom\u00e9tricos (di\u00e2metro da art\u00e9ria e veia espl\u00eanicas, di\u00e2metros espl\u00eanicos: longitudinal, transversal e \u00e2ntero-posterior); b) par\u00e2metros velocim\u00e9tricos do fluxo nos vasos espl\u00eanicos (velocidade de pico sist\u00f3lico na art\u00e9ria espl\u00eanica e velocidade m\u00e9dia de fluxo na veia espl\u00eanica); c) \u00edndice biom\u00e9trico do ba\u00e7o (longitudinal x transversal); d) \u00edndice volum\u00e9trico do ba\u00e7o (longitudinal x transversal x \u00e2ntero-posterior x 0,523); e) \u00edndices hemodin\u00e2micos de imped\u00e2ncia na art\u00e9ria espl\u00eanica (pulsatilidade e resistividade). RESULTADOS: Nos pacientes com anastomose esplenorrenal distal observaram-se: a) redu\u00e7\u00e3o - \u00edndice volum\u00e9trico (n\u00e3o-operados 903,83 \u00b1 452,77 cm\u00b3\/anastomose esplenorrenal distal 482,32 \u00b1 208,02 cm\u00b3 (46,64%)) e biom\u00e9trico espl\u00eanico (n\u00e3o-operados 138,14 \u00b1 51,89 cm\u00b2\/anastomose esplenorrenal distal 94,83 \u00b1 39,83 cm\u00b2 (33,35%)); b) aus\u00eancia de varia\u00e7\u00e3o - art\u00e9ria espl\u00eanica: di\u00e2metro (n\u00e3o-operados 0,57 \u00b1 0,16 cm\/anastomose esplenorrenal distal 0,57 \u00b1 0,23 cm)), velocidade de pico sist\u00f3lico na art\u00e9ria espl\u00eanica (n\u00e3o-operados 107 \u00b1 42,02 cm\/seg\/ anastomose esplenorrenal distal 89,81 \u00b1 41,20 cm\/seg)), \u00edndice de resistividade (n\u00e3o-operados 0,58 \u00b1 0,008\/anastomose esplenorrenal distal 0,56 \u00b1 0,06)) e \u00edndice de pulsatilidade (n\u00e3o-operados 0,91 \u00b1 0,19\/anastomose esplenorrenal distal 0,86 \u00b1 0,15); - veia espl\u00eanica (n\u00e3o-operados 1,10 \u00b1 0,30 cm\/anastomose esplenorrenal distal 1,19 \u00b1 0,29 cm)); c) aumento - da velocidade m\u00e9dia de fluxo na veia espl\u00eanica (n\u00e3o-operados 20,54 \u00b1 8,45 cm\/seg\/anastomose esplenorrenal distal 27,83 \u00b1 9,29 cm\/seg)). CONCLUS\u00d5ES: A compara\u00e7\u00e3o dos exames ultra-som-Doppler entre os dois grupos (n\u00e3o-operados e anastomose esplenorrenal distal) mostrou que nos pacientes com esquistossomose mans\u00f4nica hepatoespl\u00eanica e operados de anastomose esplenorrenal distal h\u00e1 redu\u00e7\u00e3o dos \u00edndices biom\u00e9trico e volum\u00e9trico do ba\u00e7o; n\u00e3o h\u00e1 modifica\u00e7\u00e3o dos par\u00e2metros morfol\u00f3gicos e hemodin\u00e2micos nem dos \u00edndices velocim\u00e9tricos da art\u00e9ria espl\u00eanica; h\u00e1 aumento da velocidade m\u00e9dia de fluxo na veia espl\u00eanica.<\/jats:p>","DOI":"10.1590\/s0004-28032002000400003","type":"journal-article","created":{"date-parts":[[2005,4,15]],"date-time":"2005-04-15T14:19:59Z","timestamp":1113574799000},"page":"217-221","source":"Crossref","is-referenced-by-count":0,"title":["Altera\u00e7\u00f5es morfol\u00f3gicas e hemodin\u00e2mica tardias no territ\u00f3rio espl\u00eanico de pacientes com esquitomosse mans\u00f4nica hepatoespl\u00eanica p\u00f3s-anastomose esplenorrenal distal . (Estudo com ultra-som Doppler)"],"prefix":"10.1590","volume":"39","author":[{"given":"Azzo","family":"Widman","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilka Regina Souza de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manlio Bas\u00edlio","family":"Speranzini","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni Guido","family":"Cerri","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William Abr\u00e3o","family":"Saad","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaquim","family":"Gama-Rodrigues","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"21","article-title":"Distal splenorenal shunts (Warren's operation) B-mode and real time ultrasonographic assessment","volume":"6","author":"Abdel Wahab MF","year":"1979","journal-title":"Egypt J Bilharz","ISSN":"http:\/\/id.crossref.org\/issn\/0301-8849","issn-type":"print"},{"key":"ref2","first-page":"143","article-title":"The distal splenorenal shunt in patients with variceal bleeding due to schistosomal hepatic fibrosis","volume":"163","author":"Bessa SM","year":"1987","journal-title":"Surg Gynecol Obstet","ISSN":"http:\/\/id.crossref.org\/issn\/0039-6087","issn-type":"print"},{"issue":"3","key":"ref3","first-page":"29","article-title":"Sobre o quadro anat\u00f4mico do f\u00edgado na forma 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