Acute pylephlebitis secondary to perforated sigmoid diverticulitis: A case report

Wali, Luqman; Shah, Amit; Sleiman, Stefan; Høgsand, Tord; Humphries, Sasha

doi:10.1016/j.radcr.2021.03.042

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Articles published in languages other than English; cases where clinical, microbiological, or radiological studies did not support the diagnosis; case reports not providing an adequate amount of information, as well as those reporting non-human subjects were excluded from the analyses. The final number of articles included was 101, which resulted in total number of 103 patients [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ,…”

Section: Methodsmentioning

confidence: 99%

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

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Suppurative portal vein thrombosis (pylephlebitis) is an uncommon condition usually associated with an intra-abdominal infection or inflammatory process. In this study, we aimed to synthesize data on previously published cases according to the PRISMA guidelines. A total of 103 patients were included. Patients were more commonly male (71.8%) and had a mean age of 49 years. The most common infection associated with pylephlebitis was diverticulitis (n = 29, 28.2%), and Escherichia coli was the most isolated pathogen (n = 21, 20.4%). Blood cultures were positive in 64 cases (62.1%). The most common site of thrombosis was the main portal vein (PV) in 59 patients (57.3%), followed by the superior mesenteric vein (SMV) in 40 patients (38.8%) and the right branch of the PV in 30 patients (29.1%). Sepsis developed in 60 patients (58.3%). The mortality rate in our review was 8.7%, and independent risk factors for mortality were the presence of pertinent comorbidities (OR 5.5, p = 0.02), positive blood cultures (OR 2.2, p = 0.02), and sepsis (OR 17.2, p = 0.049).

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Section: Methodsmentioning

confidence: 99%

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

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“…Las tasas de administración de terapia anticoagulante en la pileflebitis han aumentado en los últimos años, prescribiéndose aproximadamente entre el 78% y el 85% de los pacientes, en comparación con tasas anteriores más bajas que oscilaban entre el 37% y el 69% de los pacientes (Wali et al, 2021). Estudios anteriores (Hale et al, 2019;Ozawa & Shikino, 2021;Wang et al, 2021) han encontrado que la administración de anticoagulantes puede aumentar las tasas de recanalización de la vena porta para reducir las complicaciones asociadas con la hipertensión portal crónica.…”

Section: Tratamientounclassified

Manejo de la pileflebitis como complicación post apendicectomía

Jordán Oña,

Loaiza Merino

2024

rgn

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La pileflebitis es una complicación rara pero grave, asociada a riesgos como abscesos hepáticos, sepsis, e insuficiencia hepática aguda que repercute como trombosis de la vena porta post-apendicectomía. Por ello el objetivo del estudio fue evaluar la efectividad de los protocolos de atención y manejo para la pileflebitis post-apendicectomía, con el fin de identificar las mejores prácticas clínicas y mejorar el cuidado de los pacientes. Se realizó una revisión sistemática de literatura científica, aplicando un muestreo no probabilístico por conveniencia. Se seleccionaron 40 trabajos científicos publicados entre 2018 y 2023, utilizando bases de datos como PubMed/Medline, Elsevier Scopus, Science Direct, y Taylor & Francis. Los resultados revelaron que la pileflebitis post-apendicectomía presenta una incidencia baja, que afecta predominantemente a hombres, con síntomas como fiebre y dolor abdominal. Las causas más frecuentes son la diverticulitis y la apendicitis aguda. El tratamiento preferido incluye antibióticos de amplio espectro y, en algunos casos, anticoagulantes. La investigación sugiere la necesidad de protocolos de atención estandarizados para optimizar el manejo de esta complicación.

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Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosis

et al. 2023

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Pylephlebitis, defined as infective thrombophlebitis of the portal vein, is a rare condition with an incidence of 0.37–2.7 cases per 100,000 person-years, which can virtually complicate any intra-abdominal or pelvic infections that develop within areas drained by the portal venous circulation. The current systematic review aimed to investigate the etiology behind pylephlebitis in terms of pathogens involved and causative infective processes, and to report the most common symptoms at clinical presentation. We included 220 individuals derived from published cases between 1971 and 2022. Of these, 155 (70.5%) were male with a median age of 50 years. There were 27 (12.3%) patients under 18 years of age, 6 (2.7%) individuals younger than one year, and the youngest reported case was only 20 days old. The most frequently reported symptoms on admission were fever (75.5%) and abdominal pain (66.4%), with diverticulitis (26.5%) and acute appendicitis (22%) being the two most common causes. Pylephlebitis was caused by a single pathogen in 94 (42.8%) cases and polymicrobial in 60 (27.2%) cases. However, the responsible pathogen was not identified or not reported in 30% of the included patients. The most frequently isolated bacteria were Escherichia coli (25%), Bacteroides spp. (17%), and Streptococcus spp. (15%). The treatment of pylephlebitis consists initially of broad-spectrum antibiotics that should be tailored upon bacterial identification and continued for at least four to six weeks after symptom presentation. There is no recommendation for prescribing anticoagulants to all patients with pylephlebitis. However, they should be administered in patients with thrombosis progression on repeat imaging or persistent fever despite proper antibiotic therapy to increase the rates of thrombus resolution or decrease the overall mortality, which is approximately 14%.

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Acute pylephlebitis secondary to perforated sigmoid diverticulitis: A case report

Cited by 3 publications

References 6 publications

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Manejo de la pileflebitis como complicación post apendicectomía

Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosis

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