Asunto(s)
Hipertensión Portal/etiología , Esquistosomiasis/complicaciones , Adolescente , Adulto , Anciano , Dióxido de Carbono/sangre , Niño , Várices Esofágicas y Gástricas/etiología , Femenino , Hemorragia Gastrointestinal/etiología , Humanos , Hipertensión Pulmonar/etiología , Hipoxia/etiología , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Respiración , Schistosoma mansoni , Esquistosomiasis/sangre , Esquistosomiasis/fisiopatologíaRESUMEN
In 5 patients with portal hypertension caused by schistosomiasis, the sinusoidal pressure (wedged hepatic pressure) varied from 20.7 to 35.4 mm Hg. While the catheter was in an occluded position within the hepatic vein and the patients were undergoing splenectomy, the main trunk of the hepatic artery was clamped. The sinusoidal pressures then fell to levels that varied from 3.7 to 7.4 mm Hg but returned to previous levels when the clamping was released. Wedged hepatic venous pressure levels, which were significantly greater than portal venous pressure values, decreased minimally after splenectomy. Portal venous pressure levels, however, fell to 63% of presplenectomy levels. In a control case with an enlarged spleen (cavernous hemangioma, but with a normal liver, the wedged hepatic pressure was 7.4 mm Hg and showed no alteration after clamping of hepatic artery. These data point out the importance of hepatic artery hypertrophy, that has already been demonstrated in other studies, in causing elevation of the wedged hepatic pressure in advanced hepatic schistosomiasis.
Asunto(s)
Arteria Hepática , Hipertensión Portal/complicaciones , Esquistosomiasis/complicaciones , Adolescente , Adulto , Presión Sanguínea , Ensayos Clínicos como Asunto , Femenino , Arteria Hepática/patología , Humanos , Hipertensión Portal/fisiopatología , Hipertrofia , Masculino , Esquistosomiasis/patología , Esquistosomiasis/fisiopatología , Esplenectomía , Presión VenosaRESUMEN
Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.
