Tromboflebite pélvica séptica em puérpera: relato de caso

Rolim, Mayanna Oliveira; Nobre, Nadiejda Mendonça Aguiar; Barbosa, Marcelo Lopes; Gonçalves, Emilcy Rebouças; Martins, Danielle Mourão; Nogueira, Camila Sampaio

doi:10.20513/2447-6595.2019v59n4p70-73

Cited by 1 publication

(4 citation statements)

References 10 publications

(14 reference statements)

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“…1-Endothelial damage: resulting either from injury to the tunica intima of the pelvic vein secondary to disseminated uterine infection, bacteremia, and endotoxins; or from the trauma of childbirth or surgery. 3 2-Venous stasis: consequence of the tripled diameter of the ovarian vein due to pregnancy, with an increase in blood volume of about 60 times and consequent ovarian valve incompetence, together with low ovarian venous pressures in the postpartum period that promote the collapse of the pelvic veins, resulting in stagnation of blood inside them (5,7) . Thus, retrograde ovarian venous flow from the left uterine and ovarian veins into the right ovarian vein, with persistent anterograde flow in the right ovarian vein, promotes the higher frequency of thrombophlebitis in the right ovarian vein in postpartum.…”

Section: Discussionmentioning

confidence: 99%

“…The chosen conduct was conservative: antibiotic therapy associated with systemic anticoagulation, which has been safe since the 1960s and is well accepted 5,2 . Although the use of anticoagulation therapy remains controversial, its use in the treatment of TPS is recommended by many authors in order to prevent new thromboemboli and to reduce the spread of septic emboli.…”

Section: Discussionmentioning

confidence: 99%

“…Although the use of anticoagulation therapy remains controversial, its use in the treatment of TPS is recommended by many authors in order to prevent new thromboemboli and to reduce the spread of septic emboli. (5,7) .…”

Section: Discussionmentioning

confidence: 99%

“…The treatment has been modified with the development of new research. Going from a surgical approach to clinical, with a significant reduction in mortality (1,5) .…”

Section: Introductionmentioning

confidence: 99%

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Extensive septic pelvic thrombophlebitis in a puerperal woman: a case report

Armstrong¹,

Barili²,

Monteiro³

et al. 2023

ISJHR

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OBJECTIVE: This article aims to report an extensive case of septic pelvic thrombophlebitis, a rare, severe, and challenging diagnostic condition. The clinical picture may range from mild to severe sepsis. Its diagnosis is of exclusion, but it can be complemented with imaging exams. CASE DESCRIPTION: We report a case of postpartum thrombophlebitis in the infrarenal portion of the inferior vena cava, external and internal common iliac veins, bilateral common femoral veins, as well as in the right ovarian vein, presenting with persistent fever and negative cultures. The patient showed significant clinical improvement after association of anticoagulation and antibiotic therapy. CONCLUSION: Septic pelvic thrombophlebitis is an important differential diagnosis for abdominal pain and fever in the postpartum period, but the absence of specific complementary tests makes its diagnosis challenging, which often leads to misdiagnosis of acute appendicitis, endometritis, pelvic inflammatory disease, pyelonephritis, nephrolithiasis, adnexal torsion, or pelvic abscess. The key to correct diagnosis is a high level of clinical suspicion, especially when there is resistance to broad-spectrum antibiotic therapy and remission after systemic anticoagulation. Given the large number of cesarean sections performed today and their correlation with septic pelvic thrombophlebitis, an increase in the number of cases should be accompanied by greater familiarity of health professionals with this complication, in order to avoid inadequate propaedeutics and conducts. In this context, the present case report documents the importance of investigating pelvic septic thrombosis in patients with fever in the puerperium and its differential diagnoses for early initiation of therapy to reduce morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The treatment has been modified with the development of new research. Going from a surgical approach to clinical, with a significant reduction in mortality (1,5) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations