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Revista Colombia Médica
Universidad del Valle - Facultad de Salud
ISSN: 0120-8322
EISSN: 1657-9534
Vol. 36, No. 4s3, 2005, pp. 15-18
Bioline Code: rc05073
Full paper language: Spanish
Document type: Research Article
Document available free of charge

Revista Colombia Médica, Vol. 36, No. 4s3, 2005, pp. 15-18

 en Not derivative surgical technique for portal hypertension in children
Iván Cruz-Álvarez , Evenildo Martínez, José del Canto de la Rosa

Abstract

INTRODUCTION: Portal hypertension is a complex illness havig too many complications. In order to solve them, several surgical techniques have been described. The present paper offers authors' experience about this theme.
CASES REPORT: This study was made with 10 children suffering portal hypertension of prehepatic cause due to portal vein obstruction. In all of the patients a partial splenectomy was carried out in which the 2/3 superiors of the spleen were excised up with a ligature of the right gastroepyploics and coronary stomachal vessels. There were 8 boys and 2 girls from 3 to 7 years-old. All of them had thrombocytopenia with figures between 10.000 and 30.000 U/l platelets although without bleeding signs in the surgery moment, neither of the gastrointestinal tract nor at other levels, in spite of the fact that all have had multiple bleeding episodes with averages from 6 to 10 per year. In all of the children the hypersplenism was solved favourably; in none the spleen has grown again and in all there has been decrease of the bleeding episodes with an average from 1 to 3 (maximum) and even 2 of them have bled never again.
CONCLUSIONS: Since the results given in this paper are very good, it is proposed that the technique used in this investigation is a good treatment alternative for patients such as the children here studied.

Keywords
Portal hypertension; Hypersplenism; Not derivative technique; Children.

 
 es Técnica quirúrgica no derivativa para la hipertensión portal en niños. Informe de casos
Iván Cruz-Álvarez , Evenildo Martínez, José del Canto de la Rosa

Resumen

INTRODUCCIÓN: La hipertensión portal es una enfermedad compleja con muchas complicaciones y para resolverlas se han descrito diversas técnicas quirúrgicas. El presente trabajo ofrece la experiencia de los autores en este tema.
INFORME DE CASOS: La investigación se hizo con 10 niños que sufrían hipertensión portal de causa prehepática por trombosis de la porta. A todos se les realizó una esplenectomía parcial donde se resecaron los 2/3 superiores del bazo con ligadura de los vasos gastroepiploicos derechos y coronario estomáquicos. Se trata de 8 niños y 2 niñas cuyas edades oscilaban entre 3 y 7 años. Todos tenían trombocitopenia con cifras entre 10.000 y 30.000 U/l aunque sin signos de sangrado en el momento de operarse, ni del tracto grastrointestinal ni a otros niveles y todos habían tenido múltiples episodios de sangrados digestivos de 6 a 10 anuales. En todos se resolvió el hiperesplenismo, en ninguno ha vuelto a crecer el bazo y en todos ha habido disminución de los episodios de sangrado con promedio de 1 a 3 (máximo) e incluso 2 de ellos nunca han vuelto a sangrar.
CONCLUSIONES: Se considera que la técnica empleada es una buena alternativa de tratamiento para casos como los de estos niños.

Palabras-clave
Hipertensión portal; Hiperesplenismo; Técnica no derivativa; Niños.

 
© Copyright 2005 - Revista Colombia Médica
Alternative site location: http://colombiamedica.univalle.edu.co

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