Q-TC interval variations after portal decompression with different shunt operations in hepato-splenic schistosomiasis

ABSTRACT

1 23 patients of hepato-splenic bilharziasis with history of ruptured oesophago-gastric varices belonging to child's classification A. were subjected to portal decompression by shunt operations comprising 5 patients for interposition mesocaval shunt and 18 for distal Lieno-renal. 2. Pre-operative biochemical, hematologic, electrolytes, radiology, endoscopic E.C.G. and pathology studies as well as percutaneous trans-splenic portal manometry were carried out for them. 3. Post-operative biochemical and E.C.G. assessement were done for all patients. Follow up portal manometry for patients subjected to mesocaval operation and endoscopic assessement of the varices for patients subjected to Warren's operation were done to evaluate portal decompression. 4. An important comparative follow up E.C.G. finding was progressive significant shortening of Q-1c interval 3 and 6 months after Warren's, but not mesocaval operations, the causes of which were discussed. 5. Such finding can offer valuable achievement as regard assessment of emodynamic efficacy of the type of shunt concerning portal decompression portal perfusion, a non-invasive E.C.G. follow up tool to evaluate persistance of shunt patency and finally a possible indicator for shunt occlusion