The hepatosplenic form of schistosomiasis mansoni with bleeding esophageal varices is not common in children. However when it occurs, it may determine severe implications of their whole productive life. Splenectomy ligature of the left gastric vein and endoscopic sclerosis of the varices in the cases of recurrent bleeding has been one of the surgical approaches. Autologous implantation of spleen tissue in the greater omentum has been added in children. There are evidences that immunologic and filtration splenic functions persist, at least in part, after splenectomy and splenic autologous implantation induced by trauma. However similar studies were not conducted in children with schistosomiasis who underwent splenectomy, ligature of the left gastric vein and autologous implantation of spleen tissue into an omental pouch of the greater omentum. Blood smears were repeatedly studied for evidence of Howell-Jolly bodies, which indicate insufficiency of filtration splenic junction. The splenosis was proved by hepatosplenic scintigraphic sulfur colloid 99m Technetium scan. Splenosis was evident in all children, however in two patients there were less than five splenic nodules in the greater omentum, which was considered insufficient. Howell-Jolly bodies were found in the peripheral blood only in these two patients with less evident splenosis. The results seem to indicate that splenic autologous implantation in the greater omentum is an effective method for producing splenosis and maintaining the filtration splenic function.
Schistosomiasis mansoni; Splenectomy; Spleen tissue implantation; Splenosis