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]

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. [mayoclinic.pure.elsevier.com]

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]

• Fever

  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]

  He reported abdominal pain, fever, diarrhea and jaundice three weeks before his admission to the emergency department. [medwave.cl]

  She returned 4 days later complaining of fever and poor appetit, associated with minimal abdominal symptoms. [shmabstracts.com]

  Department of Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey Correspondence to Dr Cisel Yazgan, yazgancisel{at}hotmail.com Statistics from Altmetric.com Description A 55-year-old man was admitted to the emergency department, with high fever [casereports.bmj.com]

• 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]

  […] lower quadrant pain (appendicitis) or generalized abdominal pain (peritonitis) may also be evident in some cases. [2,3,4,5] Vomiting Additionally, patient may have several other non specific complaints such as nausea, vomiting, fatigue, diarrhea, and anorexia [explainmedicine.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]

  In addition, chills, anorexia, weight loss, nausea and vomiting may also occur. [en.ahealthportal.com]

  The clinical picture is not specific: temperature with a fever, belly-aches, anorexia, are possible ascites and jaundice. [medicine-for-you.com]

• Chills

  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]

  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]

  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]

  loss. [1,3,5] Complications Hepatic abscess is most commonly reported. [explainmedicine.com]

  A 40-year-old man with prolonged fever and weight loss, case 25-2005. N Engl J Med 2005;353(7):713–722. [Published correction appears in N Engl J Med 2005;353(26):2827.] Crossref, Medline, Google Scholar 15 Birnbaum BA, Wilson SR. [pubs.rsna.org]

  A 40-year-old man with prolonged fever and weight loss. N Engl J Med, 2005. 353(7): p. 713-22. Pelsang, R.E., et al., Management of suppurative pylephlebitis by percutaneous drainage: placing a drainage catheter into the portal vein. [ghrnet.org]

• Anemia

  The most common laboratory data are leukocytosis, elevated alkaline phosphatase, mild anemia and a high erythrocyte sedimentation rate. [en.ahealthportal.com]

  Lab tests are usually nonspecific, but the most common abnormal labs include leukocytosis, elevated AST/ALT, and anemia ( 3 ). [ncbi.nlm.nih.gov]

• Abdominal Pain

  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]

  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]

  Case report: 55-year-old male, who began with abdominal pain located in the left iliac fossa. The physical exam revealed peritoneal irritation. [medigraphic.com]

  He reported abdominal pain, fever, diarrhea and jaundice three weeks before his admission to the emergency department. [medwave.cl]

• 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]

  Skip to content Pylephlebitis: A Challenging Diagnosis Otto J Leiti, MD*, University of Michigan, Ann Arbor, MI Case Presentation: We present a case of 37y.o. woman, a previously healthy visiting scholar from China, who presented with nausea, vomiting [shmabstracts.org]

  […] 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]

  Patients may initially present with non-specific abdominal pain, nausea and sepsis in the context of an intra-abdominal infection. Sequelae from hepatic involvement such as jaundice or hepatomegaly may occur in advanced stages. [radiopaedia.org]

• 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]

  Skip to content Pylephlebitis: A Challenging Diagnosis Otto J Leiti, MD*, University of Michigan, Ann Arbor, MI Case Presentation: We present a case of 37y.o. woman, a previously healthy visiting scholar from China, who presented with nausea, vomiting, diarrhea [shmabstracts.org]

  A 22 year old man presented with fever, abdominal pain, weight loss and diarrhea. Past medical history revealed recurrent aseptic meningitis, uveitis, and erythema nodosum. [ncbi.nlm.nih.gov]

• Periumbilical Pain

  He was in his usual state of health until one week prior to presentation, when he began feeling chills and ill-defined periumbilical pain. The patient also reported experiencing dizziness, headache, and decreased appetite. [ncbi.nlm.nih.gov]

• Epigastric Pain

  A 47-year-old man presented to the Emergency Department complaining of fever, epigastric pain, and jaundice. [ncbi.nlm.nih.gov]

  CASE REPORT The patient, a 27-year-old Hispanic male with no past medical or surgical history, presented to the emergency department (ED) with a chief complaint of fevers, chills and intermittent epigastric pain for 5 days. [westjem.com]

  Case Presentation A 56-year-old female, with a history of a repaired Tetralogy of Fallot and pulmonary embolism while on warfarin, presented with epigastric pain and melena. [cureus.com]

• Hepatomegaly

  Hepatomegaly with segmental hypodense areas in both lobes. [medwave.cl]

  Sequelae from hepatic involvement such as jaundice or hepatomegaly may occur in advanced stages. Thrombosis of the portal circulation rapidly leads to bowel ischemia, necrosis and perforation. [radiopaedia.org]

  splenomegaly, and jaundice Hepatomegaly, splenomegaly, and jaundice Leukocytosis, neutropenia, elevated GGT, and elevated alk phos Leukocytosis, neutropenia, elevated GGT, and elevated alk phos Imaging studies – CT scan, or abdominal ultrasound can [slideplayer.com]

• 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]

• Skin Discoloration

  CASE REPORT The 37-year-old man had a 5-days duration of fever, chills, small amount of watery diarrhea and yellowish skin discoloration. [e-sciencecentral.org]

Thrombophilia workup demonstrated heterozygosity for factor V Leiden and the prothrombin G20210A mutation. [ncbi.nlm.nih.gov]

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]

Provides all the necessary tools to make a comprehensive diagnostic workup including data from ancillary techniques and molecular findings whenever appropriate. [books.google.com]

• Staphylococcus Aureus

  The most common infective organism is Staphylococcus aureus, but coagulase-negative staphylococci, enteric gram-negative bacilli, and enterococci are also frequently implicated. [13] Impaired local defense, as well as a heavy burden of skin inoculum, [emedicine.medscape.com]

  aureus, Streptococcus species ). [e-sciencecentral.org]

• Pancreatic Necrosis

  Acute ascending infection of portal vein and its tributaries often arising from primary GI inflammatory lesion (common: diverticulitis, appendicitis, infected pancreatic necrosis). High mortality rate of more than 50%. [radiologyinthai.blogspot.com]

  DISCUSSION Diverticulitis, inflammatory bowel disease (both colitis and ileitis), appendicitis, intestinal obstruction, infected pancreatic necrosis, gastric ulceration and sepsis affecting the biliary tree are all well recognised causes of pylephlebitis [wjgnet.com]

  On the other hand, the infection may spread to the tree from the biliary tract or superinfected pancreatic necrosis. [elsevier.es]

  Twelve patients had intra-abdominal abscesses as the initial septic focus leading to pylephlebitis; none of these had polymicrobial bacteremia; 5 patients with pancreatic necrosis had polymicrobial bacteremia. [ncbi.nlm.nih.gov]

Antibiotic treatment was adjusted and treatment with enoxaparin 60 mg every 12 hours was begun. The clinical outcome was favorable. [medigraphic.com]

Treatment should be individualized to culture results and extent of thrombosis. [mayoclinic.pure.elsevier.com]

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]

Anticoagulant treatment was therefore suspended. [elsevier.es]

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]

"— 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]

[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]

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]

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]

Etiology septic focus diverticulitis is the most common cause appendicitis necrotizing pancreatitis hypercoagulative status trauma abdominal surgery hepatobiliary diseases: cirrhosis, hepatocellular carcinoma Ultrasound Findings on color duplex sonography [radiopaedia.org]

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]

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]

The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. Clinical cases. [scienceopen.com]

Hepatic - Portal venous gas in adults: Etiology, pathophysiology and clinical significance. Ann Surg. 1978;187(3):281-287. https://doi.org/10.1097/00000658-197803000-00012 [ Links ] 4. Shin AR, Lee CK, Kim HJ, et al. [scielo.org.za]

Hepatic--portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg. 1978; 187 :281-287. [ PubMed ] [ DOI ] [wjgnet.com]

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]

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]

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]