Analysis of 95 cases at our institution showed that pylephlebitis can present in any age group in the adult population and is associated with multiple possible causes. [ncbi.nlm.nih.gov]

Presentation[edit] 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]

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

  Clinical ManifestationsPatients usually generalised abdo pain and fever and associated features of underlying pathology.It is usually acute but can present chroni-cally. [gastroenterologybook.com]

  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]

  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]

  […] 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 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]

  Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. [ncbi.nlm.nih.gov]

  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 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]

  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]

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

  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]

• Rigor

  Presentation[edit] 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]

  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]

  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]

  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]

• Abdominal Pain

  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]

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

  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]

  2 In our case, the cause for abdominal pain and pyrexia was not clear on presentation, and abdominal imaging was not initially performed. [acgcasereports.gi.org]

  Presentation[edit] 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]

• 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]

  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]

  […] 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]

• 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 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]

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

• 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]

• Poor Oral Hygiene

  Her dental evaluation showed poor oral hygiene, multiple retained roots, pulpal necrosis, and mobile teeth. Repeated blood cultures grew Actinomyces meyeri. [cureus.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]

• Liver Mass

  Abdominal computed tomography showing low attenuation masses in the right lobe of the liver with differential perfusion. Figure 2. Thrombus in the right portal vein. [westjem.com]

• 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]

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]

Hypercoagulable workup revealed the presence of antiphospholipid antibodies. The patient showed clinical and radiologic improvement with appropriate antibiotic and anticoagulant therapy. Figure 1. [westjem.com]

• Haemophilus Parainfluenzae

  Abdominal CT revealed portal vein thrombus and blood cultures grew Streptococcus milleri and Haemophilus parainfluenza type V. [acgcasereports.gi.org]

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

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]

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]

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]

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]

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 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]

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]

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 Shin AR, Lee CK, Kim HJ, et al. [sajr.org.za]

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]