Edit concept Question Editor Create issue ticket

Pylephlebitis


Presentation

  • The authors present a case of pylephlebitis after perforated retrocecal appendicitis in a child and discuss the etiology, presentation, diagnosis, and treatment of this disorder in the modern era.[ncbi.nlm.nih.gov]
  • Pylephlebitis with an uncommon aetiology This supplementary information is presented as submitted by the corresponding author. It has not been copy-edited by NTvG .[ntvg.nl]
  • We report an elderly woman with pylephlebitis presenting with fever, abdominal pain, diarrhea, and vomiting, likely secondary to a polypectomy 6 weeks prior.[acgcasereports.gi.org]
Fever
  • He reported abdominal pain, fever, diarrhea and jaundice three weeks before his admission to the emergency department.[medwave.cl]
  • Drainage resulted in a dramatic decrease in fever. Postoperative radiographic studies of the colon, the small intestine, and other organs did not show any abnormalities.[ncbi.nlm.nih.gov]
  • In this report, we described a 67-year-old man with chief complaint of bouts of high fevers and mild abdominal tenderness located in right lower quadrant. The patient suffered from pylephlebitis secondary to cecal diverticulitis.[govaresh.org]
  • The most common symptoms include fever and abdominal pain, with the majority of cases manifesting with a polymicrobial bacteremia.[acgcasereports.gi.org]
Anorexia
  • In this case report, we describe a case of a 60-year-old man who presented with a two-week-history of general malaise, anorexia, fever and right-sided abdominal pain.[sciedupress.com]
  • The clinical picture is nonspecific: fever with chills, abdominal pain, anorexia, jaundice and ascites are possible.[medicalformat.com]
  • The clinical picture is not specific: temperature with a fever, belly-aches, anorexia, are possible ascites and jaundice.[medicine-for-you.com]
  • The clinical presentation of pylephlebitis is nonspecific, common symptoms being fever, abdominal pain, nausea, diarrhea, and anorexia; however, a presentation of jaundice accompanied by fever and abdominal pain should raise the suspicion of the disease[ncbi.nlm.nih.gov]
Chills
  • Clinical features depend on the aetiology of the abdominal infection, but presenting symptoms on the emergency department often are fever, cold chills and abdominal pain.[ntvg.nl]
  • We report a 42-year-old patient with a protein S deficiency who presented with fever and chills, in whom idiopathic pylephlebitis was diagnosed. A year later, the patient was readmitted because of recurrent vomiting and weight loss.[ncbi.nlm.nih.gov]
  • A 50-year-old Caucasian male with a history of asthma and a family history of venous thrombosis presented to the emergency department with the complaint of intermittent chest pain for 1 week, associated with progressive shortness of breath, fever, chills[westjem.com]
  • A 62-year-old Caucasian woman with a history of sigmoid diverticulitis presented to our facility with a three-week history of abdominal pain, fevers, chills, loss of appetite and fatigue.[d-scholarship.pitt.edu]
Weight Loss
  • A year later, the patient was readmitted because of recurrent vomiting and weight loss. An exploratory laparotomy yielded diagnosis of sclerosing peritonitis, which resolved after surgery.[ncbi.nlm.nih.gov]
Rigor
  • It typically presents with fever, rigors, and right upper quadrant abdominal pain, but sometimes abdominal pain may be absent. Liver function test abnormalities are usually present but frank jaundice is uncommon.[en.wikipedia.org]
  • Despite fluid resuscitation, on the second day of admission, the patient was tachycardic, hypotensive, and continued to experience diarrhea and rigors.[acgcasereports.gi.org]
  • Case History A 71 years old man was admitted with a four-week history of nausea, vomiting, rigors and mild right iliac fossa pain.[wjgnet.com]
  • Fever is accompanied with chills and rigors. [1,2,3,4] Abdominal pain This can present in some patients. Right upper quadrant abdominal pain can be severe and depends on the patency of the portal vein.[explainmedicine.com]
  • One day after the biopsy, the patient developed a high fever with chills and rigors. On admission, she was febrile to 39 C. Abdominal examination revealed normal bowel sounds with mild right upper quadrant tenderness without hepatomegaly or ascites.[ajronline.org]
Cough
  • She is unemployed, a former tobacco smoker quitting in 1993, she denied alcohol or recreational drug use, has no significant family history, and is allergic to angiotensin-converting enzyme (ACE) inhibitors (cough).[jmedicalcasereports.biomedcentral.com]
Abdominal Pain
  • In hindsight the patient remembered to have choked when eating something from a cocktail stick, after which the right upper quadrant abdominal pain started.[ntvg.nl]
  • A 16-year old male patient who was diagnosed with CD 3 months earlier was admitted with recurrent fever and abdominal pain. CD activity had been well controlled with conventional medical treatment during a follow-up period.[ncbi.nlm.nih.gov]
  • He reported abdominal pain, fever, diarrhea and jaundice three weeks before his admission to the emergency department.[medwave.cl]
  • The most common symptoms include fever and abdominal pain, with the majority of cases manifesting with a polymicrobial bacteremia.[acgcasereports.gi.org]
Nausea
  • Case Presentation: We present a case of 37y.o. woman, a previously healthy visiting scholar from China, who presented with nausea, vomiting, diarrhea and vague diffuse abdominal discomfort . Her initial laboratory results were essentially normal.[shmabstracts.com]
  • Case presentation A 61-year-old white woman was hospitalized for acute onset abdominal pain and nausea.[jmedicalcasereports.biomedcentral.com]
  • […] a 61-year-old white woman with a history of end-stage renal disease on hemodialysis, paroxysmal atrial fibrillation not on long-term systemic anticoagulation, and history of recurrent diverticulitis that presented with acute onset abdominal pain and nausea[ncbi.nlm.nih.gov]
  • , vomiting, headache Abdominal pain, fever, nausea, vomiting, headache Hepatomegaly, splenomegaly, and jaundice Hepatomegaly, splenomegaly, and jaundice Leukocytosis, neutropenia, elevated GGT, and elevated alk phos Leukocytosis, neutropenia, elevated[slideplayer.com]
Diarrhea
  • Case Presentation: We present a case of 37y.o. woman, a previously healthy visiting scholar from China, who presented with nausea, vomiting, diarrhea and vague diffuse abdominal discomfort . Her initial laboratory results were essentially normal.[shmabstracts.com]
  • We report an elderly woman with pylephlebitis presenting with fever, abdominal pain, diarrhea, and vomiting, likely secondary to a polypectomy 6 weeks prior.[acgcasereports.gi.org]
  • A 58-year-old woman had fever, diarrhea, and polymicrobial bacteremia that progressively worsened despite appropriate antibiotic therapy.[ncbi.nlm.nih.gov]
Loss of Appetite
  • A 62-year-old Caucasian woman with a history of sigmoid diverticulitis presented to our facility with a three-week history of abdominal pain, fevers, chills, loss of appetite and fatigue.[d-scholarship.pitt.edu]
  • Case presentation A 62-year-old Caucasian woman with a history of sigmoid diverticulitis presented to our facility with a three-week history of abdominal pain, fevers, chills, loss of appetite and fatigue.[jmedicalcasereports.biomedcentral.com]
  • She was discharged from hospital with a pyelonephritis diagnosis. 18 days later she returned because of maintained fever and loss of appetite. She denied other symptoms.[eurorad.org]
Choking
  • In hindsight the patient remembered to have choked when eating something from a cocktail stick, after which the right upper quadrant abdominal pain started.[ntvg.nl]
Aphthous Ulceration
  • Further inquiry unveiled a prominent history of oral aphthous ulcers; all features of Behçet's disease.[ncbi.nlm.nih.gov]
Liver Dysfunction
  • In advanced cases appears liver dysfunction and jaundice. Bacteriemia is present in 50-80% of patients and B. fragilis, E. coli and Streptococcus are the most common microorganisms isolated (1,2).[scielo.isciii.es]
Costovertebral Angle Tenderness
  • Physical examination revealed mild tenderness on deep palpation of all abdominal quadrants with no costovertebral angle tenderness. Serum lactate was elevated at 2.5 mmol/L, otherwise admission laboratory tests were normal (Table 1).[acgcasereports.gi.org]

Workup

  • Initial workup revealed leukocytosis and elevated aminotransferase levels that indicated possible cholangitis. Despite broad-spectrum antibiotic therapy, the patient did not have clinical improvement.[nejm.org]
  • Thrombophilia workup demonstrated heterozygosity for factor V Leiden and the prothrombin G20210A mutation.[ncbi.nlm.nih.gov]
Hyponatremia
  • Hematology and chemistry panels were significant for neutrophilic leukocytosis (14.5 k/mm 3 ), mild normocytic anemia (9.8 g/dL), hyponatremia (128 mEq/L), and hyperkalemia (6.1 mEq/L).[jmedicalcasereports.biomedcentral.com]
Normocytic Anemia
  • Hematology and chemistry panels were significant for neutrophilic leukocytosis (14.5 k/mm 3 ), mild normocytic anemia (9.8 g/dL), hyponatremia (128 mEq/L), and hyperkalemia (6.1 mEq/L).[jmedicalcasereports.biomedcentral.com]
Haemophilus Parainfluenzae
  • Abdominal CT revealed portal vein thrombus and blood cultures grew Streptococcus milleri and Haemophilus parainfluenza type V.[acgcasereports.gi.org]
Polyps
  • A snare polypectomy was performed for a large sessile polyp during colonoscopy 8 months earlier.[acgcasereports.gi.org]

Treatment

  • When it came to treatment, despite controversies about the use of anticoagulants, administration of antibiotics and anticoagulants was still the mainstay of treatment.[govaresh.org]
  • Antibiotic treatment was adjusted and treatment with enoxaparin 60 mg every 12 hours was begun. The clinical outcome was favorable.[medigraphic.com]
  • We decided to start treatment with intravenous metronidazole 750 mg three times a day for 21 days.[medwave.cl]
  • The patient had recovered due to timely antibiotic treatment alone and resulted in complete resolution. Early diagnosis and treatment are basic to a favorable clinical course.[e-sciencecentral.org]
  • Early diagnosis is essential for the treatment of pylephlebitis. Antibiotics and anticoagulants are the mainstay of treatment for pylephlebitis; although the use of anticoagulants remains controversial.[ncbi.nlm.nih.gov]

Prognosis

  • The frequency and the prognosis of this complication are unknown. The aim of this study was to determine the global and relative incidence of the most frequent intra-abdominal infections and the real prognosis of this disease.[ncbi.nlm.nih.gov]
  • [Journal Article] VS Vasc Specialist Int 2018; 34(4):83-87 Cho JW, Choi JJ, … Jun H CONCLUSIONS: SMVT, caused by intraperitoneal inflammation, unlike portal vein thrombosis including pylephlebitis, shows mild prognosis.[unboundmedicine.com]
  • "— Presentation transcript: 1 Pylephlebitis Megan Brundrett October 19, 2009 2 Outline Etiology Etiology Microbiology Microbiology Clinical Manifestations Clinical Manifestations Diagnosis Diagnosis Complications Complications Treatment Treatment Prognosis[slideplayer.com]

Etiology

  • The authors present a case of pylephlebitis after perforated retrocecal appendicitis in a child and discuss the etiology, presentation, diagnosis, and treatment of this disorder in the modern era.[ncbi.nlm.nih.gov]
  • Outline Etiology Etiology Microbiology Microbiology Clinical Manifestations Clinical Manifestations Diagnosis.[slideplayer.com]
  • Of all these etiologies, until recently, the most common cause that produced it was acute appendicitis, currently the most common etiology is documented colonic diverticulitis.[posterng.netkey.at]

Epidemiology

  • The epidemiology, clinical and radiological features as well as treatment strategies are discussed.[ncbi.nlm.nih.gov]
  • The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs 2007;67:351–368. Choudhry AJ, Baghdadi YM, Amr MA, Alzghari MJ, Jenkins DH, Zielinski MD. Pylephlebitis: a review of 95 cases.[synapse.koreamed.org]
Sex distribution
Age distribution

Pathophysiology

  • The discussion of this case highlights the anatomy of the cardiac venous system, the pathophysiology of thrombus formation, and the utility of transesophageal echocardiography in confirming a diagnosis and assessing treatment efficacy.[ncbi.nlm.nih.gov]
  • The discussion highlights the anatomy of the cardiac venous system, the pathophysiology of thrombus formation, and treatment options for this rare but potentially serious and fatal condition.[jmedicalcasereports.biomedcentral.com]
  • Hepatic - Portal venous gas in adults: Etiology, pathophysiology and clinical significance. Ann Surg. 1978;187(3):281-287. [ Links ] 4. Shin AR, Lee CK, Kim HJ, et al. Septic pylephlebitis as a rare complication of Crohn's disease.[scielo.org.za]
  • Hepatic--portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg . 1978; 187 :281-287. [ PubMed ] [ DOI ][wjgnet.com]
  • Hepatic – Portal venous gas in adults: Etiology, pathophysiology and clinical significance. Ann Surg. 1978;187(3):281–287. Shin AR, Lee CK, Kim HJ, et al. Septic pylephlebitis as a rare complication of Crohn’s disease.[sajr.org.za]

Prevention

  • Anticoagulant treatment was established with the goal of preventing the extension of the thrombus and its possible complications because it has been demonstrated that its use might prevent intestinal ischemia [11] .[medwave.cl]
  • Early and aggressive treatment with broad-spectrum antibiotics is necessary, and anticoagulation therapy can also be used to prevent bowel ischemia.[ncbi.nlm.nih.gov]
  • To put in a nutshell, as early diagnosis and treatment are essential steps for proper management of pylephlebitis and preventing its adverse complications, it is of high importance to keep this differential diagnosis in mind in patients with abdominal[govaresh.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!