Endovascular repair using a covered stent for a ruptured infected aneurysm of the superior mesenteric artery after pancreaticoduodenectomy: a case report

Yamashita, Tetsuo; Yamanaka, Kenya; Izumi, Ai; Matsui, Jun; Kurimoto, Makoto; Aoki, Hiroki; Tamura, Jun

doi:10.1186/s40792-020-01047-w

Cited by 3 publications

(5 citation statements)

References 25 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another case, even though a troublesome focus of brain abscess was diagnosed, the patient had an indolent clinical course and successfully recovered without any complications [ 7 ]. Uncommon complications include hemorrhagic shock (due to GIT bleeding), peritonitis, multi-organ failure, biloma, empyema, and intra-abdominal sepsis [ 24 , 31 , 37 , 57 , 69 , 80 ]. Thrombosis can persist, resolve (entirely or partially), or result in a cavernous transformation of the portal vein (i.e., the formation of veins within or around the previously thrombosed PV) [ 64 , 85 ].…”

Section: Discussionmentioning

confidence: 99%

“…This decrease is significant and might imply that the identification and treatment of pylephlebitis have improved over time. Sepsis was the cause of death in 88.9% of patients who died, with one patient (11.1%) dying due to pancreatic adenocarcinoma [ 37 ]. Our review found that the independent risk factors for mortality in patients suffering from pylephlebitis are positive blood cultures, pertinent comorbidities, and sepsis.…”

Section: Discussionmentioning

confidence: 99%

“…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%

See 2 more Smart Citations

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

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

View full text Add to dashboard Cite

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).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Furthermore, PSAs are associated with a high mortality rate [ 23 ]. In this scenario, prompt intervention is a cornerstone.…”

Section: Discussionmentioning

confidence: 99%

Imaging-Guided Percutaneous Puncture and Embolization of Visceral Pseudoaneurysms: Feasibility and Outcomes

Carriero

Lanza

Biondetti

et al. 2022

JCM

View full text Add to dashboard Cite

Visceral artery pseudoaneurysms (VAPAs) are the most frequently diagnosed pseudoaneurysms (PSAs). PSAs can be asymptomatic or symptomatic. The aim of our study was to evaluate the safety and effectiveness of percutaneous embolization of VAPAs performed on patients with an unfeasible trans-arterial approach. Fifteen patients with fifteen visceral PSAs, with a median dimension of 21 mm (IQR 20–24 mm), were retrospectively analyzed. No patients were suitable for trans-arterial catheterization and therefore a percutaneous approach was chosen. During percutaneous treatments, two embolic agents were used, either N-butyl cyanoacrylate (NBCA) (Glubran II, GEM Milan, Italy) mixed with Lipiodol (Lipiodol, Guerbet, France) or thrombin. The outcomes of this study were technical success, primary clinical success, and secondary clinical success. In our population the 15 PSA were located as follows: 2 in the left gastric artery, 1 in the right gastric artery, 3 in the right hepatic artery, 2 in a jejunal artery, 1 in left colic artery branch, 1 in a right colic artery branch, 1 in the gastroepiploic artery, 1 in the dorsal pancreatic artery, 1 in an ileocolic artery branch, 1 in an iliac artery branch, and 1 in a sigmoid artery branch. 80% of PSAs (12/15) were treated with a NBCA:lipiodol mixture and 20% of PSAs (3/15) were treated with thrombin. Technical, primary, and secondary clinical successes were obtained in 100% of the cases. No harmful or life-threatening complications were observed. Minor complications were registered in 26.6% (4/15) of the patients. Percutaneous embolization of visceral PSA is a safe and effective treatment and should be considered as an option when the endovascular approach is unsuccessful or unfeasible.

show abstract

“…This significant decrease in mortality might suggest that the identification and treatment of pylephlebitis have improved over time. Sepsis has been found to be the cause of death in approximately 88.9% of patients [221], increasing the risk of death 17-fold [208]. Positive blood cultures were also found to be an independent risk factor for death (approximately 2.2-fold) [208].…”

Section: Complications and Mortalitymentioning

confidence: 98%

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

et al. 2023

View full text Add to dashboard Cite

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%.

show abstract

Endovascular repair using a covered stent for a ruptured infected aneurysm of the superior mesenteric artery after pancreaticoduodenectomy: a case report

Cited by 3 publications

References 25 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

Imaging-Guided Percutaneous Puncture and Embolization of Visceral Pseudoaneurysms: Feasibility and Outcomes

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

Contact Info

Product

Resources

About