A Case of Septic Portal Vein Thrombosis (Pylephlebitis)

Carnish, Erin; Garrett, Andrew; Slome, Mary

doi:10.29046/tmf.015.1.020

Cited by 4 publications

(9 citation statements)

References 13 publications

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“…However, computed tomography (CT) is described by some authors as the most sensitive in the identifi cation of thrombi in the mesenteric veins and visualization of hepatic abscesses [7]. Corroborating with the literature, the elucidative test in this case was the tomography of the abdomen.…”

Section: Discussionmentioning

confidence: 71%

Portal vein septic thrombosis secondary to complicated appendicitis: Case report

Quaresma¹,

Saadi²,

Garcia³

et al. 2018

Arch Clin Gastroenterol

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Background: Portal vein septic thrombophlebitis is a rare and serious event of late diagnosis and secondary to intra-abdominal infection. Case report: A 21-year-old man was admitted to the hospital with loss of weight, fever, chills, hepatosplenomegaly, and history of abdominal pain in the right iliac fossa previously treated with ciprofl oxacin. At the entrance physical examination, he was emaciated and had no signs of abdominal pain upon palpation. Computed tomography showed portal vein thrombosis and nodular image in the ileocecal region, initiating antibiotic therapy. After exploratory laparotomy, appendicitis was confi rmed and hepatic collections were found. After ten days of the procedure and the end of the antibiotic therapy, he was discharged, keeping well and without complaints. Conclusions: Septic thrombophlebitis is a rare but serious complication of non-specifi c signs and symptoms, making diagnosis diffi cult. Imaging tests are necessary that show the thrombosis to close diagnosis. Treatment should be started early, with the introduction of antibiotics and eradication of the septic focus.

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Section: Discussionmentioning

confidence: 71%

Portal vein septic thrombosis secondary to complicated appendicitis: Case report

Quaresma¹,

Saadi²,

Garcia³

et al. 2018

Arch Clin Gastroenterol

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“…26,27 Pylephlebitis can be a devastating life-threatening entity; in fact, prior to the routine use of antibiotics, the mortality was estimated to be nearly 100%. 28 SARS-CoV-2 infection is a novel cause of PVT; currently, it has been attributed to the hypercoagulable state seen in COVID-19 pathology. The proposed causes of the hypercoagulable state due to COVID-19 are complex, multifactorial, and are still under investigation.…”

Section: Discussionmentioning

confidence: 99%

“…26 27 Pylephlebitis can be a devastating life-threatening entity; in fact, prior to the routine use of antibiotics, the mortality was estimated to be nearly 100%. 28…”

Section: Discussionmentioning

confidence: 99%

COVID-19-Associated Portal Vein Thrombosis Post-Cholecystitis

et al. 2022

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This case study describes a 45-year-old Caucasian male with a past medical history of obesity, hypertension, and non-insulin-dependent diabetes mellitus, who in the setting of coronavirus disease 2019 (COVID-19) pneumonia, developed portal vein thrombosis (PVT) presenting as an acute abdomen after hospital discharge from a cholecystitis episode. PVT is a very infrequent thromboembolic condition, classically occurring in patients with systemic conditions such as cirrhosis, malignancy, pancreatitis, diverticulitis, autoimmunity, and thrombophilia. PVT can cause serious complications, such as intestinal infarction, or even death, if not promptly treated. Due to the limited number of reports in the literature describing PVT in the COVID-19 setting, its prevalence, natural history, mechanism, and precise clinical features remain unknown. Therefore, clinical suspicion should be high for PVT, in any COVID-19 patient who presents with abdominal pain or associated signs and symptoms. To the best of our knowledge, this is the first report of COVID-19-associated PVT causing extensive thrombosis in the portal vein and its right branch, occurring in the setting of early-stage cirrhosis after a preceding episode of cholecystitis.

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“…Blood cultures are advised, although bacteraemia is not always detected, with reported positivity rates between 23% and 80% (1,2). When positive, organisms are usually from bowel flora, most commonly Bacteroides fragilis and Escherichia coli (7).…”

Section: Discussionmentioning

confidence: 99%

Septic thrombophlebitis of the portal vein – a case report

Louro¹,

Teixeira²,

Silva³

2021

Paediatr Croat

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Septic thrombophlebitis of the portal venous system, also known as pylephlebitis, is a rare clinical condition with nonspecific clinical presentation, in which imaging has a crucial role in its prompt diagnosis. We report a case of a 13-year-old male who presented with fever, jaundice and hepatomegaly. Ultrasound and computed tomography revealed portal vein thrombosis, hepatomegaly, splenomegaly, and mild ascites. No primary focus of infection, underlying thrombophilia or malignancy was identified, and broad-spectrum antibiotic therapy and anticoagulation were initiated, resulting in clinical improvement and partial recanalization of the portal vein. Clinical and imaging follow-up should be maintained to exclude the development of portal hypertension.

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A Case of Septic Portal Vein Thrombosis (Pylephlebitis)

Cited by 4 publications

References 13 publications

Portal vein septic thrombosis secondary to complicated appendicitis: Case report

Portal vein septic thrombosis secondary to complicated appendicitis: Case report

COVID-19-Associated Portal Vein Thrombosis Post-Cholecystitis

Septic thrombophlebitis of the portal vein – a case report

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