Decoding pylephlebitis: Tracing the path of infected thrombosis and liver abscesses

Linsen, Philip V.M.; Schrier, Verena J.M.M.

doi:10.1016/j.radcr.2023.08.054

Cited by 3 publications

(2 citation statements)

References 20 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Polymerase chain reactions have demonstrated enhanced sensitivity in identifying the etiological microorganisms in individuals with sepsis-associated pylephlebitis [1]. Commutated tomography (CT), color flow Doppler ultrasonography (US), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans are all viable methods for diagnosing pylephlebitis and detecting portal vein thrombosis [1,2,12,13]. Studies indicate that CT and US are the most commonly utilized imaging techniques [1,2,12,13].…”

Section: Diagnosis and Laboratory Evaluationmentioning

confidence: 99%

“…Commutated tomography (CT), color flow Doppler ultrasonography (US), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans are all viable methods for diagnosing pylephlebitis and detecting portal vein thrombosis [1,2,12,13]. Studies indicate that CT and US are the most commonly utilized imaging techniques [1,2,12,13]. CT has demonstrated its superiority over the US due to its capacity to identify other related problems, such as hepatic abscesses, mesenteric ischemia, and intestinal ischemia [1,2].…”

Section: Diagnosis and Laboratory Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

An Overview of the Latest Insights and Innovations in Pylephlebitis: A Comprehensive Review

Gomez Coral

2024

ARGH

View full text Add to dashboard Cite

Pylephlebitis, a rare condition marked by infective thrombosis in the portal vein, presents diagnostic and therapeutic challenges. This review explores its epidemiology, etiology, clinical manifestations, diagnosis, and treatment. Primarily a complication of intra-abdominal infections, diverticulitis and appendicitis are prevalent causes. Clinical presentation mirrors intra-abdominal infections, demanding a high index of suspicion. Diagnosis involves clinical examination, laboratory investigations, and imaging, with CT and ultrasound commonly employed. Treatment integrates broad-spectrum antibiotics and surgical interventions targeting the infection source. Prognosis, influenced by prompt diagnosis and complications, reports mortality rates of 7-30%. Early recognition and aggressive management are pivotal for favorable outcomes, emphasizing a comprehensive approach to Pylephlebitis prevention, diagnosis, and treatment.

show abstract

Section: Diagnosis and Laboratory Evaluationmentioning

confidence: 99%

Section: Diagnosis and Laboratory Evaluationmentioning

confidence: 99%

An Overview of the Latest Insights and Innovations in Pylephlebitis: A Comprehensive Review

Gomez Coral

2024

ARGH

View full text Add to dashboard Cite

show abstract

Vascular complications of liver abscess: A literature review

Arya,

Kumar,

Priyadarshi

et al. 2024

World J Meta-Anal

View full text Add to dashboard Cite

Extensive vascular network and proximity to the gastrointestinal tract make the liver susceptible to abscess formation. While pyogenic liver abscesses account for the majority of liver abscesses in the Western world, amebic liver abscesses are more prevalent in tropical and developing nations. Most liver abscesses heal without complications. However, various vascular complications can occur in these patients, including compression of the inferior vena cava, thrombosis of the portal vein and/or hepatic veins, hepatic artery pseudoaneurysm, direct rupture into major vessels or the pericardium, and biliovascular fistula. These complications can present significant clinical challenges due to the potential for haemorrhage, ischemia, and systemic embolism, thereby increasing the risk of morbidity and mortality. Mechanical compression, flow stasis, inflammation, endothelial injury, and direct invasion are some of the proposed mechanisms that can cause vascular complications in the setting of a liver abscess. For the diagnosis, thorough assessment, and therapeutic planning of vascular complications, more sophisticated imaging techniques such as multidetector computed tomography angiography or magnetic resonance angiography may be necessary. Although most vascular complications resolve with abscess treatment alone, additional interventions may be required based on the nature, severity, and course of the complications. This article aims to provide a systematic update on the spectrum of vascular complications of liver abscesses, offering insights into their pathogenesis, diagnosis, and management strategies.

show abstract

Pylephlebitis Secondary to a Gangrenous Appendicitis a Forgotten Complication. Case Report and a Review of the Literature

Silva Aguilar

2024

Revista Científica y Académica

View full text Add to dashboard Cite

Introduction: Pylephlebitis is an uncommon condition with a significant mortality which can complicate intrabdominal sepsis of any etiology. (1) Case presentation: A 22-year-old male with 2 weeks of epigastric and right upper quadrant pain with associated fever and chills, nausea and vomiting, hyperbilirubinemia and leukocytosis in blood test was documented. An acute cholangitis was the first diagnosis. Abdominal ultrasound described multiple abscesses and gallbladder wall thickening, and inflammatory changes around the gallbladder. CT scan was performed and revealed a case of acute appendicitis complicated with a thrombosis of the portal vein. Diagnostic laparoscopy was performed, here we observed an inflammatory process in the right lower quadrant, cholecystectomy with cholangiography was done with no complications, and then appendicectomy was performed. Broad-spectrum antibiotic and anticoagulation treatment led to full recovery. Follow-up after 12 months showed a full recovery and no signs of thrombosis in the serial CT scans for follow-up. Discussion: Pylephlebitis can present as a clinical cholangitis-like scenario with hyperbilirubinemia with liver abscess formation. (2) CT scan seems to be the most sensitive diagnostic test because it can identify the underlying infection foci, it also can show the extension of the thrombosis and other complications like liver abscesses (3). Surgical removal of the source of infection and adequate antibiotic treatment adjusted by culture should be initiated promptly (4). Anticoagulant treatment should be considered in the case of poor clinical outcome or thrombosis progression (5). Conclusion: Pylephlebitis should be considered in the case of poor clinical outcome of intrabdominal infections, a properly diagnosis with imaging tests and multimodal management can reduce the morbidity and mortality, and also short- and long-term complications of this pathology (6).

show abstract

Decoding pylephlebitis: Tracing the path of infected thrombosis and liver abscesses

Cited by 3 publications

References 20 publications

An Overview of the Latest Insights and Innovations in Pylephlebitis: A Comprehensive Review

An Overview of the Latest Insights and Innovations in Pylephlebitis: A Comprehensive Review

Vascular complications of liver abscess: A literature review

Pylephlebitis Secondary to a Gangrenous Appendicitis a Forgotten Complication. Case Report and a Review of the Literature

Contact Info

Product

Resources

About