Pylephlebitis and Crohn’s disease: A rare case of septic shock

Scaringi, Stefano; Giudici, Francesco; Gabbani, Giacomo; Zambonin, Daniela; Morelli, Marco Bruno; Carrà, Rossella; Bechi, Paolo

doi:10.1016/j.ijscr.2017.08.009

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…The first case of pylephlebitis was reported in 1846 during an autopsy; however, the first case in a patient with IBD was not reported until 100 years later. 5 , 6 Pylephlebitis is commonly associated with diverticulitis, pancreatitis, cholangitis, peptic ulcer disease, liver abscess, and gastroenteritis. 6 Based on our literature review, less than 10 published cases have described pylephlebitis occurring in CD and only 5 cases are published in patients with UC (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 6 Pylephlebitis is commonly associated with diverticulitis, pancreatitis, cholangitis, peptic ulcer disease, liver abscess, and gastroenteritis. 6 Based on our literature review, less than 10 published cases have described pylephlebitis occurring in CD and only 5 cases are published in patients with UC (Table 1 ). 2 , 7 These cases demonstrate a male predominance.…”

Section: Discussionmentioning

confidence: 99%

“…6 Conservative management, including intravenous fluids, antibiotics, and anticoagulation, showed improved outcomes when patients have concurrent IBD by allowing for the time to optimize health before undergoing a procedure, thus allowing for bowel-sparing surgery and minimizing complications. 6,11 Septic MVT is a medical emergency with the potential to have poor prognosis. Symptoms may be absent, nonspecific, or masked by an IBD flare or other abdominal disease; thus, clinicians should consider pylephlebitis as a differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Inferior Mesenteric Vein Thrombosis Resulting in Pylephlebitis in a Patient With Inflammatory Bowel Disease

et al. 2022

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Although uncommon, pylephlebitis is a life-threatening complication of mesenteric vein thrombosis. It is reported to affect adult men more commonly than women, with a median age of 57 years. Furthermore, few cases have been reported of pylephlebitis in patients with inflammatory bowel disease. Owing to low prevalence, there is a paucity of data regarding the diagnosis and management of pylephlebitis. Treatment approach ranges from conservative management (antibiotics and/or systemic anticoagulation) to surgical management. We report a case of a 62-year-old man diagnosed with inflammatory bowel disease with a course complicated by pylephlebitis of the inferior mesenteric vein managed successfully with antibiotics and anticoagulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inferior Mesenteric Vein Thrombosis Resulting in Pylephlebitis in a Patient With Inflammatory Bowel Disease

et al. 2022

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“…Anticoagulation is an area of controversy since no guidelines currently exist. According to the authors of one study there was a benefit observed with the combination of antibiotics and anticoagulation compared to antibiotics alone [8]. The benefits included a lower rate of mortality and recanalization failure.…”

Section: Discussionmentioning

confidence: 99%

“…The right portal vein, main portal vein, and superior mesenteric vein were each reported around 30% in one study [6]. More recent articles referencing inflammatory bowel disease are referring to Crohn’s disease and, to our knowledge, ulcerative colitis has not been mentioned since 1950 [2,8].…”

Section: Introductionmentioning

confidence: 99%

Pylephlebitis as a Rare Complication of Ulcerative Colitis: A Case Report

Hamera¹,

Abraham²,

Jordan³

2019

Cureus

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Pylephlebitis is a rare and potentially fatal complication of many common abdominal pathologies. Here we describe an unusual case of pylephlebitis associated with ulcerative colitis. A 51-year-old male with a history of ulcerative colitis, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) presented for shortness of breath, fevers, chills, and generalized weakness. The patient was discharged one week prior to this admission after being treated for an acute colitis flare and adverse reaction to sulfasalazine. The current admission was significant for fever, leukocytosis, and lactic acidosis and a portal vein thrombus seen on computed tomography scan. The presentation of sepsis and portal thrombus were consistent with pylephlebitis and he was subsequently started on antibiotics and anticoagulated. He was discharged home and made a full recovery. Here we present a unique case of pylephlebitis associated with ulcerative colitis. Ultimately this case report serves as a good reminder to stay diligent and keep a broad differential diagnosis when treating a septic patient.

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Portal-Mesenteric Suppurative Emphysematous Pylephlebitis: A Case Report

Youssef¹,

Jacques²,

Zahir³

et al. 2023

Cureus

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Suppurative thrombophlebitis of the portal-mesenteric venous system occurring in the setting of abdominal inflammatory and infectious processes is a serious condition that can lead to septic shock, bowel ischemia, hepatic abscess, and death if unrecognized. Diagnosis is often delayed because symptoms are aspecific and pain at the primary site of infection may be mild. Contrast-enhanced CT scans can diagnose both portal thrombosis and a primary infection site. Treatment may include early resective surgery in case of appendicitis or diverticulitis, in association with large-spectrum antibiotics and possibly anticoagulation. A characteristic of suppurative thrombophlebitis, whether splanchnic or systemic, is the latency before the effects of antibiotic therapy are seen. Anticoagulation can be administered to avoid extension to the superior mesenteric vein. We presented a critically ill 53-year-old man with chronic colonic diverticulitis complicated by suppurative emphysematous portal-mesenteric thrombophlebitis with only a slow response to large-spectrum antibiotics.

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Pylephlebitis and Crohn’s disease: A rare case of septic shock

Cited by 3 publications

References 11 publications

Inferior Mesenteric Vein Thrombosis Resulting in Pylephlebitis in a Patient With Inflammatory Bowel Disease

Inferior Mesenteric Vein Thrombosis Resulting in Pylephlebitis in a Patient With Inflammatory Bowel Disease

Pylephlebitis as a Rare Complication of Ulcerative Colitis: A Case Report

Portal-Mesenteric Suppurative Emphysematous Pylephlebitis: A Case Report

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