Pylephlebitis is a condition in which there is septic thrombophlebitis of the portal-mesenteric venous system. It is a rare condition that usually arises as a complication of an intra-abdominal infection or inflammation. Being rare, it may be overlooked as a differential in cases of abdominal pain when the more common causes have been excluded. We present a case of a 37-year-old Hispanic male who presented with acute abdominal pain and loose stools. He was initially treated for acute gastroenteritis but his clinical condition deteriorated. He was eventually diagnosed with pylephlebitis with associated inferior mesenteric vein thrombosis. He was successfully treated with IV antibiotics and warfarin. Pylephlebitis should not be overlooked as a differential in an appropriate clinic setting as it has a high mortality rate.

Due to the distributed and non-integrated nature of the healthcare systems which results from the application-centric view it leads to a challenging task to manage healthcare data ex change (heterogeneity problem). On the other hand, Blockchain technologies are emerging as promising and cost -effective means to meet some of these requirements due to their inherent design properties, such as secure cryptography and a resilient peer-to-peer network. Likewise, Blockchain-based applications can benefit the healthcare domain via their properties of asset sharing, and audit trails of data access. Existing work mainly pays attention to centralized and blockchain-based mechanisms. But it doesn't realize the increase need for better data interoperability amount multiple healthcare systems and services. This requires shifting from the applicationcentric solutions toward the patient-centric solutions. This paper presents A secure and efficient fram ework based on Blockchain, Cloud, and IoT named Patient -Centric Healthcare Framework (PCH) for better healthcare systems interoperability. A tiered-based architecture (5 tiers) with collaboration is designed for the feasible realization of PCH. Also, the design and implementation aspects start from the layering diagram, system context, and detailed reference architecture that emphasizes the detailed component topology and interactions within the framework. An electronic medical record is used to show how he althcare data is processed with the required security considerations. Then, an evaluation of PCH against the existing Blockchain-based healthcare frameworks is conducted. The results analysis demonstrates that PCH offers practical solutions to protect healthcare data and support efficient data sharing with better interoperability

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