Pylephlebitis: Keep it in your differential diagnosis

Rea, Jennifer D.; Jundt, Jason P.; Jamison, Richard L.

doi:10.1016/j.amjsurg.2010.02.021

Cited by 23 publications

(27 citation statements)

References 5 publications

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“…1,6–9 Additional risk factors for pylephlebitis include hypercoagulable states or clotting factor deficiencies. 10 Albeit rare, pylephlebitis has also been reported as a complication of hemorrhoidal banding, silicone gastric banding, and CT-guided liver biopsy. 11–13 …”

Section: Introductionmentioning

confidence: 99%

Pylephlebitis: a Review of 95 Cases

Choudhry

Baghdadi

Amr

et al. 2016

Journal of Gastrointestinal Surgery

143

214

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Pylephlebitis, or suppurative thrombophlebitis of the portal mesenteric venous system occurring in the setting of abdominal inflammatory processes, is a rare but deadly disease commonly associated with diverticulitis. We review our institutional experience in the management of patients with this condition. A retrospective review of medical records from 2002 to 2012 was performed. Patients with a portal mesenteric vein thrombosis (PMVT) within 30 days of an intra-abdominal inflammatory process were identified and evaluated. Ninety-five patients were included. The mean patient age at presentation was 57 years (range, 24–88). The most common associated processes were pancreatitis (31 %), followed by diverticulitis (19 %). Bacteremia was noted in 34 (44 %) patients. The most common organism cultured was Streptococcus viridans. Antibiotic and anticoagulation therapy was given in 86 (91 %) and 78 (82 %) patients, respectively. Overall, we report an 11 % mortality rate. Albeit rare, pylephlebitis most commonly was manifested in the setting of pancreatitis. Treatment should be individualized to culture results and extent of thrombosis. If diagnosed early and managed appropriately, a favorable outcome is possible.

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Section: Introductionmentioning

confidence: 99%

Pylephlebitis: a Review of 95 Cases

Choudhry

Baghdadi

Amr

et al. 2016

Journal of Gastrointestinal Surgery

143

214

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“…While diverticulitis is thought to be the leading cause of this disease, it has also been described in appendicitis, cholecystitis, hemorrhoidal disease, necrotizing pancreatitis, and various other suppurative intra-abdominal infections 1. The disease was first described by Waller in 1846 as a source of pyogenic intrahepatic abscesses 2. Prior to the advent of antibiotics, this condition was almost universally fatal.…”

Section: Discussionmentioning

confidence: 99%

“…Fever is the most common presenting symptom, followed by abdominal pain, which is often vague and poorly localized 1,2. Nausea, vomiting, scleral icterus and a tender, enlarged liver may also be present in some cases, especially in those complicated by liver abscesses 1,4.…”

Section: Discussionmentioning

confidence: 99%

Pylephlebitis in a Previously Healthy Emergency Department Patient with Appendicitis

Coyne¹,

Jain²

2013

WestJEM

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Pylephlebitis is a septic thrombophlebitis of the portal vein that is associated with multiple suppurative abdominal infections, such as diverticulitis, appendicitis, cholangitis, and cholecystitis. We describe a case of pylephlebitis in a patient with fever and diffuse, poorly localized abdominal pain who was eventually diagnosed with appendicitis. We aim to increase awareness of this condition among emergency physicians, as timely initiation of antibiotics and expedited surgical resection may improve outcomes in this potentially fatal disease.

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“…Beside appendicitis, colonic diverticulitis, inflammatory bowel diseases, bowel perforation, pancreatitis or cholangitis are potential triggers [1]. Furthermore, malignancies or hypercoagulable conditions may act as predisposing factors [2]. …”

Section: Discussionmentioning

confidence: 99%

“…Anticoagulants are administered in an effort to recanalise the thrombotic vein and reduce the possibility of septic embolisation and abscess formation in the liver [2]. In cases where bowel ischemia encounters as complication, a thrombectomy could be indicated.…”

Section: Discussionmentioning

confidence: 99%

Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

Kykalos

Sotiropoulos

Vernadakis

2011

Case Reports in Medicine

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Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy.

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Pylephlebitis: Keep it in your differential diagnosis

Cited by 23 publications

References 5 publications

Pylephlebitis: a Review of 95 Cases

Pylephlebitis: a Review of 95 Cases

Pylephlebitis in a Previously Healthy Emergency Department Patient with Appendicitis

Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

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