Abstract
In cases treated surgically at the authors' department, Banti's syndrome was studied from the viewpoint of portal pressure. The results are as follows:
1. Using control data from 50 surgical cases of gastric and other upper abdominal diseases, the upper limit of normal portal pressure was estimated to be 200 mm H2O.
2. Of 66 cases of Banti's syndrome examined, the portal pressure was above normal in 59 cases (89.4 per cent) and within the normal range in seven (10.6 per cent). Approximately half of the cases showed a pressure between 300 mm H2O and 400 mm H2O.
3. On late investigations, 19 of 21 cases with pre-operative portal pressure ranging from 300 to 400 mm H2O and all five cases with the pressure more than 400 mm H2O were found to be alive in good condition several years after splenec tomy, indicating that splenectomy was capable of providing patients of Banti's syndrome with a long life span even when they were associated with a considerably elevated portal pressure.
4. The incidence of hematemesis after splenectomy was as low as 3.1 per cent. compared to that of 28.1 per cent before operation. No significant difference was detected in end-result of splenectomy between cases with preoperative episodes of hematemesis and those without hematemesis. These results suggest that splenectomy can inhibit occurrence of hematemesis, to a large extent, without further surgery.
5. X-ray examinations of the esophagus at various post-operative stages revealed a complete disappearance or significant improvement of esophageal varices in 75 per cent of the cases. No cases without pre-operative varices developed them after splenectomy.
6. These results were interpreted to suggest the significance of a splenic factor or factors in pathogenesis of Banti's syndrome.
