Suppurative Pylephlebitis and Multiple Hepatic Abscesses With Silent Colonic Diverticulitis

Waxman, Bruce P.; Cavanagh, Lucia; Nayman, Jack

doi:10.5694/j.1326-5377.1979.tb104191.x

Cited by 15 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This can secondarily lead to an infection of the larger mesenteric veins and the whole portal venous system [ 5 ]. Furthermore, thrombophlebitis in small veins can lead stepwise to hypercoagulopathy and finally to septic embolism [ 4 , 6 , 7 ]. The superior mesenteric vein is involved in 42% followed by the portal vein (39%) and splenic vein (12%) [ 4 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Jejunal Diverticulosis Probably Leading to Pylephlebitis of the Superior Mesenteric Vein

Bockmeyer

Taha‐Mehlitz

Heeren

et al. 2020

Case Reports in Surgery

View full text Add to dashboard Cite

Thrombophlebitis of the portal vein (pylephlebitis) is a rare but serious condition with a high mortality rate of 11-50%. A 56-year-old male patient presented with a two-day history of postprandial, colic-like epigastric pain, nausea, fever, chills, and diarrhea. Clinical workup showed peritonism, leukocytosis, and elevated C-reactive protein (CRP). A computed tomography (CT) scan revealed a long-segment, partial thrombosis of the superior mesenteric vein as well as gas in the portal venous system. Additionally, extensive jejunal diverticulosis was present. Pylephlebitis mostly results from intestinal infections, e.g., appendicitis or diverticulitis. We assumed that the patient had suffered from a self-limiting episode of jejunal diverticulitis leading to septic thrombosis. Initially, antibiotic therapy and anticoagulation with heparin were administered. The patient deteriorated, and due to increasing abdominal defense, fever, and hypotension, a diagnostic laparoscopy was performed. Bowel ischemia could be ruled out, and after changing antibiotic therapy, the patient’s condition improved. He was discharged without any further complications and without complaints on day 13. An underlying coagulopathy like myeloproliferative neoplasm or antiphospholipid syndrome could be ruled out.

show abstract

Section: Discussionmentioning

confidence: 99%

Jejunal Diverticulosis Probably Leading to Pylephlebitis of the Superior Mesenteric Vein

Bockmeyer

Taha‐Mehlitz

Heeren

et al. 2020

Case Reports in Surgery

View full text Add to dashboard Cite

show abstract

“…The most common causes of portal pylephlebitis are diverticulitis, acute appendicitis, inflammatory bowel disease, pancreatitis, and gastroenteritis [9]. However, according to Waxman et al [11], the primary cause was not clearly identified in 70% of the cases. Pylephlebitis is usually diagnosed with an abdominal infection and portal vein thrombosis on abdominal CT, showing poor prognosis, with 11% to 32% mortality [1,2].…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations of Superior Mesenteric Venous Thrombosis in the Era of Computed Tomography

Cho

Choi

et al. 2018

VSI

View full text Add to dashboard Cite

PurposeThrombosis of the portal vein, known as pylephlebitis, is a rare and fatal complication caused by intraperitoneal infections. The disease progression of superior mesenteric venous thrombosis (SMVT) is not severe. This study aimed to determine the clinical features, etiology, and prognosis of SMVT.Materials and MethodsWe retrospectively reviewed the medical records of 41 patients with SMVT from March 2000 to February 2017. We obtained a list of 305 patients through the International Classification of Disease-9 code system and selected 41 patients with SMVT with computed tomography. Data from the medical records included patient demographics, comorbidities, review of system, laboratory results, clinical courses, and treatment modalities.ResultsThe causes of SMVT were found to be intraperitoneal inflammation in 27 patients (65.9%), malignancy in 7 patients (17.1%), and unknown in 7 patients (17.1%). Among the patients with intraperitoneal inflammation, 14 presented with appendicitis (51.9%), 7 with diverticulitis (25.9%), and 2 with ileus (7.4%). When comparing patients with and without small bowel resection, the differences in symptom duration, bowel enhancement and blood culture were significant (P=0.010, P=0.039, and P=0.028, respectively).ConclusionSMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis. In addition, rapid symptom progression and positive blood culture can be the prognostic factors related to extensive bowel resection. Use of appropriate antibiotics and understanding of disease progression can help improve the outcomes of patients with SMVT.

show abstract

“…A recent abdominal surgery can also predispose to pylephlebitis (3). However, in a study done by Waxman et al ., they found that a primary source of infection could not be identified in 70% of patients (4). There is also little data to support any inherited coagulopathies as an underlying etiology (3).…”

Section: Discussionmentioning

confidence: 99%

Pylephlebitis: a rare complication of an intra-abdominal infection

Wong

Weisman

Patrice

2013

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition.

show abstract

Suppurative Pylephlebitis and Multiple Hepatic Abscesses With Silent Colonic Diverticulitis

Cited by 15 publications

References 9 publications

Jejunal Diverticulosis Probably Leading to Pylephlebitis of the Superior Mesenteric Vein

Jejunal Diverticulosis Probably Leading to Pylephlebitis of the Superior Mesenteric Vein

Clinical Manifestations of Superior Mesenteric Venous Thrombosis in the Era of Computed Tomography

Pylephlebitis: a rare complication of an intra-abdominal infection

Contact Info

Product

Resources

About