The authors studied 30 schistosomotic patients between 1987 to 1991, previously submitted to non-decompressive surgery for the treatment of upper gastrointestinal hemorrhage who rebled after the surgery. Upper digestive endoscopy, abdominal ultrasonography and angiographic study were carried out in this patients with the aim of trying to detemine the source of rebleeding, and possible factors correlated to this new onset of bleeding. An attempt was also made to determine the influence of previous surgery in the free-time interval from bleding till the first episode of upper hemorrhage. 1t was concluded that esophageal varices are the most common site of bleeding in the rebleeding (86.7%). It was found that peptic gastric ulcer (13.3%) non-gastroesophagic devascularization (30%), uncomplet devascularization (16.7%), and portal thrombosis (26.7%), are present in most cases of rebleeding. It was also found that the association of the gastroesophagic devascularization to esplenectomy did not significantly alter the average time interval between previous surgery and first episode of the rebleeding.
Portal hypertension; Esophageal and gastric varices; Mansonic schistosomiasis