Percutaneous Management of Suppurative Pylephlebitis

Dean, John W.; Trerotola, Scott O.; Harris, Veronica J.; Snidow, John J.; Hawes, Donald R.

doi:10.1016/s1051-0443(95)71141-1

Cited by 22 publications

(21 citation statements)

References 11 publications

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“…2 Patients with this disease have fever, chills, malaise, anorexia, and abdominal pain with tenderness in the right upper quadrant. [1][2][3] Pylephlebitis has often been detected as a complication of intra-abdominal diseases such as acute appendicitis, 4,5 pyogenic cholangitis, 13 alcohol abuse, 14 or acute or chronic pancreatitis. 1,2 In particular, pancreatitis is known to cause portal vein thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, only four cases have yet been reported. 1,2,14 In the past, needle aspiration for pylephlebitis was considered to be contraindicated by some authors for fear of spreading the infection. 8 Historically, surgical drainage of suppurative pylethrombophlebitis has resulted in extremely high mortality, 9,11 whereas only a few cases in which surgical drainage was effective have been reported.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis

et al. 2007

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Suppurative pylethrombophlebitis is an extremely rare disease with high mortality. It is difficult to diagnose this disease because its nonspecific clinical features are unfamiliar to physicians. A 64-year-old Asian man, who had undergone a longitudinal pancreaticojejunostomy for alcoholic chronic pancreatitis 7 years before, had right upper abdominal pain and high fever. Abdominal sonography and contrast-enhanced abdominal computed tomography detected thrombus and fluid collection in the portal vein. After a percutaneous needle puncture, the patient was diagnosed as having suppurative pylethrombophlebitis and treated with only drainage and antibiotics; no operation was required. This case suggests that minimally invasive percutaneous needle puncture of the intrahepatic portal vein may be an accurate procedure for the appropriate diagnosis and treatment of suppurative pylethrombophlebitis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis

et al. 2007

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“…It may result from contiguous extension of a periportal infection or from infectious seeding (39). Pylephlebitis is predominantly caused by gram-negative bacilli and manifests with nonspecific abdominal pain and sepsis (39)(40)(41). Untreated pylephlebitis has a high mortality (50%) owing to bowel ischemia from propagation of portal venous thrombi, hepatic abscess formation, and overwhelming sepsis (39,41).…”

Section: Pylephlebitismentioning

confidence: 99%

“…Treated pylephlebitis has a low mortality 0%-12% (39). Pylephlebitis requires prolonged culture-specific systemic antibiotic therapy with or without percutaneous drainage of hepatic abscesses and portal pyemia (40,41). Routine use of anticoagulant therapy is controversial.…”

Section: Pylephlebitismentioning

confidence: 99%

“…On contrast-enhanced CT images, an infected portal thrombus appears as a low-attenuation, tubular filling defect that expands the portal vein or its tributaries (Fig 15). Portal pyemia may appear as tubular structures with the attenuation of fluid, simulating dilated biliary ducts, and air-pyemia levels may be seen (40,41). On sonograms, an acute thrombus appears hyperechoic, and gas within the portal venous system appears as hyperechoic shadowing foci.…”

Section: Pylephlebitismentioning

confidence: 99%

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Imaging Assessment of Congenital and Acquired Abnormalities of the Portal Venous System

Lee¹,

Chang²,

Duddalwar³

et al. 2011

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Abnormalities of the portal venous system are a heterogeneous group of conditions that can cause substantial morbidity and mortality and may lead to complications during surgery or percutaneous interventions involving the portal venous system. High-resolution computed tomography, ultrasonography, and magnetic resonance imaging permit a comprehensive, noninvasive evaluation of the portal venous system, enabling the detection of both structural and functional abnormalities. However, an understanding of the embryologic development of the normal portal venous anatomy and anatomic variants is essential to accurately interpret the imaging findings. Knowledge of the characteristic appearances of abnormalities of the portal venous system allows a more confident diagnosis, permitting timely treatment and more informed guidance of surgical procedures and percutaneous interventions, which may lead to an improved outcome.

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Percutaneous Drainage of Suppurative Pylephlebitis Complicating Acute Pancreatitis

Nouira

Bedioui

Azaiez

et al. 2007

Cardiovasc Intervent Radiol

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Percutaneous Management of Suppurative Pylephlebitis

Cited by 22 publications

References 11 publications

Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis

Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis

Imaging Assessment of Congenital and Acquired Abnormalities of the Portal Venous System

Percutaneous Drainage of Suppurative Pylephlebitis Complicating Acute Pancreatitis

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