2010, Number 5
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Cir Cir 2010; 78 (5)
Septic thrombophlebitis of the portal vein due to acute cholecystitis
Menéndez-Sánchez P, Gambí-Pisonero D, Villarejo-Campos P, Padilla-Valverde D, Martín-Fernández J
Language: Spanish
References: 12
Page: 439-441
PDF size: 247.26 Kb.
ABSTRACT
Background: Pylephlebitis is a rare complication of intraabdominal infections. Clinical presentation can be varied; therefore, it is necessary to carry out imaging tests for diagnosis. The treatment of choice is wide-spectrum antibiotic therapy and surgery for the source of infection.
Clinical case: We report the case of a female with acute abdomen who was diagnosed with acute cholecystitis and right portal vein thrombosis. The patient underwent surgery and antibiotic treatment was necessary. CT scan showed hepatic infarction secondary to portal thrombosis.
Conclusions: Pylephlebitis presents high mortality rates without treatment; therefore, early diagnosis is necessary in order to initiate appropriate medical and surgical treatment.
REFERENCES
Álvarez M, Rodrigo S, González JJ, Hernández L, Martínez-Rodríguez E. Pylephlebitis due to acute appendicitis. Rev Esp Enferm Dig 2007;99:59-60.
Levin C, Koren A, Miron D, Lumelsky D, Nussinson E, Siplovich L, et al. Pylephlebitis due to perforated appendicitis in a teenager. Eur J Pediatr 2008;168:633-635.
Justo Firvida E, Beatriz Mangupli P, Lado Lado F, Salvador Griboff E. Septic thrombophlebitis of the portal vein. Rev Clin Esp 1993;192:248-249.
Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis 1995;21:1114-1120.
Lee BK, Ryu HH. A case of pylephlebitis secondary to cecal diverticulitis. J Emerg Med. 2009 May 12. [Epub ahead of print].
Bogue CO, Leahy TR, Rea DJ, Bitnun A, Brandao LR, Kahr WH, et al. Idiopathic suppurative pylephlebitis: interventional radiological diagnosis and management. Cardiovasc Intervent Radiol 2009;32:1304-1307.
Arteche E, Ostiz S, Miranda L, Caballero P, Jiménez G. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases. An Sist Sanit Navar 2005;28:417-420.
Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr 2000;24:755-760.
Tsao YT, Lin SH, Cheng CJ, Chang FY. Pylephlebitis associated with acute infected choledocholithiasis. Am J Med Sci 2006;332:85-87.
Baril N, Wren S, Radin R, Ralls P, Stain S. The role of anticoagulation in pylephlebitis. Am J Surg 1996;172:449-452.
Singh P, Yadav N, Visvalingam V, Indaram A, Bank S. Pylephlebitis. Diagnosis and management. Am J Gastroenterol 2001;96:1312-1313.
Sherigar R, Amir KA, Bobba RK, Arsura EL, Srinivas N. Abdominal pain secondary to pylephlebitis: an uncommon disease of the portal venous system, treated with local thrombolytic therapy. Dig Dis Sci 2005;50:983-987.