Ammonia Metabolism and Hepatic Coma in Hepatosplenic Schistosomiasis
Authors: KENNETH S. WARREN
Journal: Annals of Internal Medicine (1965)

Article1 June 1965Ammonia Metabolism and Hepatic Coma in Hepatosplenic SchistosomiasisPatients Studied Before and After Portacaval ShuntKENNETH S. WARREN, M.D., D.T.M.&H., GILBERTO REBOUÇAS, M.D., AUGUSTO GENTIL BAPTISTA, M.D.KENNETH S. WARREN, M.D., D.T.M.&H.Search for more papers by this author, GILBERTO REBOUÇAS, M.D.Search for more papers by this author, AUGUSTO GENTIL BAPTISTA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-6-1113 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHepatosplenic schistosomiasis, a widespread disease syndrome in large areas of the tropics, is a relatively unique clinical and pathophysiological entity. Extensive portal-systemic collateral circulation in the presence of only minimal liver parenchymal damage is frequently encountered (1-4). Other forms of chronic intrahepatic liver disease are more complicated, in that they are a combination of both circulatory derangements and hepatocellular malfunction (5).Clinical investigation of patients with hepatosplenic schistosomiasis should offer an opportunity to dissociate the effects of collateral circulation and parenchymal damage and thus elucidate some of the physiological and biochemical problems that are encountered in chronic liver disease. The...References1. GARCIA-PALMIERIMARCIAL-ROJAS MRRA: Portal hypertension due to schistosomiasis mansoni. Amer. J. Med. 27: 811, 1959. CrossrefMedlineGoogle Scholar2. RODRIGUEZGARCIA-PALMIERIRIVERARODRIGUEZ-MOLINA HFMRJVR: Comparative study of portal and bilharzial cirrhosis. Gastroenterology 29: 235, 1955. CrossrefMedlineGoogle Scholar3. AUFSESSCHAFFNERROSENTHALHERMAN AHFWSBE: Portal venous pressure in "pipestem" fibrosis of the liver due to schistosomiasis. Amer. J. Med. 27: 807, 1959. CrossrefMedlineGoogle Scholar4. 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REDEKERGELLERREYNOLDS AGHMTB: Hepatic wedge pressure, blood flow, vascular resistance and oxygen consumption in cirrhosis before and after end-to-side portacaval shunt. J. Clin. Invest. 37: 606, 1958. CrossrefMedlineGoogle Scholar29. WARRENREBOUÇAS KSG: Blood ammonia during bleeding from esophageal varices in patients with hepato-splenic schistosomiasis. New Eng. J. Med. 271: 921, 1964. CrossrefMedlineGoogle Scholar30. BESSMAN SP: Ammoniagenic coma. The chemistry of an endogenous intoxication, in Proceedings of the Fourth International Congress of Biochemistry, Vol. 3, Vienna, 1958, p. 141. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: KENNETH S. WARREN, M.D., D.T.M.&H.; GILBERTO REBOUÇAS, M.D.; AUGUSTO GENTIL BAPTISTA, M.D.Affiliations: Bahia,From the Department of Medicine, University of Bahia, Bahia, Brazil.Requests for reprints should be addressed to Kenneth S. Warren, M.D., Department of Preventive Medicine, Wearn Research Building, University Hospitals, Cleveland, Ohio 44106. 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