Introduction And Importance: Pylephlebitis is a rare and life threatening thrombophlebitis of the portal vein. It commonly occurs following intra abdominal infections like appendicitis.It is even rarer in the pediatric age group. The nonspecific presentation impedes the diagnosis. Timely use of appropriate antibiotics and control of infection is paramount in its treatment and this case report highlights the same.
Case Presentation: 11 year old female child from a rural area was referred from a local hospital for persistent fever and abdominal pain despite medical treatment. Workup revealed perforated appendicitis, pylephlebitis, and multiple liver abscess. She was successfully treated with appendicectomy followed by antibiotics and anticoagulants.
Clinical Discussion: Pylephlebitis secondary to appendicitis was frequently lethal in the pre-antibiotic era. Doppler ultrasonography and CT scan are the investigations of choice to establish the diagnosis by showing a thrombus in the portal vein. With use of antibiotics, early diagnosis by imaging and surgical control of the primary infection, appendicitis-associated-pylephlebitis now has improved outcomes. Larger scale studies are required to establish the role of anticoagulants.
Conclusion: Early diagnosis and intervention of this fatal condition is life saving but numerous gaps exist in the literature regarding the treatment recommendation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577868 | PMC |
| http://dx.doi.org/10.1016/j.amsu.2022.104744 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pylephlebitis Secondary to Diverticulitis Diagnosed by Abdominal Ultrasound and Computed Tomography.
Cureus
November 2024
Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba / University of Tsukuba Hospital, Tsukuba, JPN.
Pylephlebitis is a rare infection, characterized by non-specific symptoms such as abdominal pain, that often leads to delayed diagnosis, yet it is a severe infection with a high mortality rate. Imaging studies are essential for diagnosis, and contrast-enhanced abdominal CT and abdominal ultrasound are commonly performed. A 51-year-old male was admitted to the hospital with fever and shock.
View Article and Find Full Text PDFA Case of Pylephlebitis Without Intra-abdominal Infection Secondary to Pneumonia Caused by Hypermucoviscous Klebsiella pneumoniae.
Cureus
September 2024
Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, JPN.
Article Synopsis
- - Pylephlebitis is a serious condition characterized by the infection and inflammation of the portal vein, often arising from abdominal infections.
- - The case discussed involves a patient with hypermucoviscous pneumonia who developed pylephlebitis, treated with antibiotics and anticoagulants, but ultimately suffered liver failure.
- - Persistent bacteremia after pneumonia can lead to complications like portal vein inflammation, highlighting the need for thorough monitoring and investigation in such cases.
Pylephlebitis combined with septic shock secondary to acute nonperforated appendicitis: a case report.
J Int Med Res
April 2024
Department of Hepatobiliary and Pancreatic Surgery, The Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, PR China.
Pylephlebitis, which is a type of septic thrombophlebitis of the portal vein, is a rare and life-threatening complication that commonly occurs following appendicitis. However, nonspecific abdominal complaints and fever can impede the diagnosis of pylephlebitis. Timely use of appropriate antibiotics and anticoagulants is paramount for treating this condition.
View Article and Find Full Text PDFSeptic thrombophlebitis of portal and splenic vein secondary to Fusobacterium nucleatum: A case report of an abdominal variant of lemierre syndrome.
Medicine (Baltimore)
October 2023
Department of Radiology, One Brooklyn Health- Interfaith Medical Center, NY.
Rationale: Septic thrombophlebitis of the internal jugular vein also known as Lemierre syndrome occurs secondary to an oropharyngeal infection often leading to septic embolisms to distant sites. Anaerobic gram-negative bacillus, Fusobacterium nucleatum and Fusobacterium necrophorum are commonly isolated organisms. Fusobacterium species has also been reported to complicate an intra-abdominal infection leading to septic thrombophlebitis of portal vein also known as pylephlebitis or abdominal variant of lemierre syndrome.
View Article and Find Full Text PDFDecoding pylephlebitis: Tracing the path of infected thrombosis and liver abscesses.
Radiol Case Rep
November 2023
Department of Radiology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, The Netherlands.
Pylephlebitis, a septic thrombophlebitis of the portal vein, is an uncommon but serious complication following an abdominal site of infection, most frequently diverticulitis or appendicitis. It has a high mortality rate, yet it commonly presents with unspecific abdominal complaints and fever, making diagnosis by clinical and laboratory examinations alone, impossible. This report highlights the extensive computed tomography (CT) findings of pylephlebitis with multiple hepatic abscesses thought to be secondary to diverticulitis, in a patient presenting with septic shock.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!