Fulminant hepatic failure secondary to amebic abscesses

Saltzman, David A.; Smithline, Neil; Davis, John R.

doi:10.1007/bf01072703

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…The diagnosis is often delayed due to the rare incidence of pylephlebitis and presentation with nonspecific symptoms. Especially in the past, the diagnosis was made by laparotomic detection of portal vein thrombosis [67,72,85] or in postmortem studies [19,79,90]. However, due to the high accessibility of modern imaging techniques, portal vein thrombosis can be promptly detected.…”

Section: Diagnosismentioning

confidence: 99%

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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Section: Diagnosismentioning

confidence: 99%

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

et al. 2023

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“…The correct diagnosis in these patients could be reached only with the help of radiology, amoebic serology and liver scan. Toxaemia is not an uncommon presentation of ALA 19 , and is suggestive of an added bacterial infection leading to a more severe disease.…”

Section: Special Features In Alamentioning

confidence: 99%

“…Hepatic encephalopathy is rarely reported in patients with ALA 17 , 20 . It possibly results from a combination of right hepatic venous occlusion, pyelophlebitis and occlusion of several portal vein radicles 19 .…”

Section: Special Features In Alamentioning

confidence: 99%