Acute appendicitis with superior mesenteric vein septic thrombophlebitis

Chang, Pi-Kai; Hsu, Kuo–Feng; Yu, Jyh‐Cherng; Chang, Yuan-Min; Chan, De-Chuan; Liao, Guo‐Shiou

doi:10.1016/j.jcma.2012.02.012

Cited by 7 publications

(9 citation statements)

References 9 publications

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“…The primary inflammatory diseases can be acute appendicitis, diverticulitis, Crohn disease, pancreatitis, cholecystitis, intraabdominal infection, and intrapelvic infection. 1 Blood cultures could be positive in nearly 80% of the patients, and Bacteroides fragilis , E coli , Proteus mirabilis , Clostridium species , Klebsiella , Pneumococcus , Aerobacter , and Streptococcus have been reported as causative microorganisms. 1 – 3 The incidence of pylephlebitis complicating appendicitis has become less since the advent of modern antibiotic therapy and aggressive surgical treatment of appendicitis.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Blood cultures could be positive in nearly 80% of the patients, and Bacteroides fragilis , E coli , Proteus mirabilis , Clostridium species , Klebsiella , Pneumococcus , Aerobacter , and Streptococcus have been reported as causative microorganisms. 1 – 3 The incidence of pylephlebitis complicating appendicitis has become less since the advent of modern antibiotic therapy and aggressive surgical treatment of appendicitis. 1 , 3 However, the reported mortality rate of pylephlebitis from all causes is still as high as 30 to 50%.…”

Section: Discussionmentioning

confidence: 99%

“… 1 – 3 The incidence of pylephlebitis complicating appendicitis has become less since the advent of modern antibiotic therapy and aggressive surgical treatment of appendicitis. 1 , 3 However, the reported mortality rate of pylephlebitis from all causes is still as high as 30 to 50%. 1 , 4 This is partly because of the delay in the diagnosis due to nonspecific manifestation and a low index of suspicion, which might lead to intestinal infarction, liver abscess, and septic shock.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 3 However, the reported mortality rate of pylephlebitis from all causes is still as high as 30 to 50%. 1 , 4 This is partly because of the delay in the diagnosis due to nonspecific manifestation and a low index of suspicion, which might lead to intestinal infarction, liver abscess, and septic shock.…”

Section: Discussionmentioning

confidence: 99%

“…Thrombophlebitis of the portomesenteric veins is a kind of pylephlebitis which is normally associated with intraperitoneal septic conditions, including acute appendicitis, colonic diverticulitis, and cholangitis. 1 With the advances in antibiotic therapy, the incidence of portomesenteric veins thrombosis as a complication of acute appendicitis has become very low. However, the mortality rate remains high, due to the nonspecific symptoms and low index of suspicion.…”

Section: Introductionmentioning

confidence: 99%

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Intestinal Infarction Caused by Thrombophlebitis of the Portomesenteric Veins as a Complication of Acute Gangrenous Appendicitis After Appendectomy

Tang¹,

Tian

Xie³

et al. 2015

Medicine

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The clinical symptoms of pylephlebitis caused by acute appendicitis are varied and atypical, which leads to delayed diagnosis and poor outcomes. Here, we report a case of intestinal necrosis caused by thrombophlebitis of the portomesenteric veins as a complication of acute appendicitis after appendectomy.The patient had acute abdominal pain with tenderness and melena on the 3rd day after appendectomy for the treatment of gangrenous appendicitis. He was diagnosed with intestinal infarction caused by thrombophlebitis of the portomesenteric veins based on enhanced CT and diagnostic abdominal paracentesis. The patient was treated by bowel excision anastomosis and thrombectomy. After postoperative antibiotic and anticoagulation treatments, the patient recovered well and was discharged 22 days after the 2nd operation. A follow-up CT scan showed no recurrence of portomesenteric veins thrombosis 3 months later.Thrombophlebitis of the portomesenteric veins is a rare but fatal complication of acute appendicitis. For all the cases with acute abdominal pain, the possibility of thrombophlebitis should be considered as a differential diagnosis. Once pylephlebitis is suspected, enhanced CT scan is helpful for early diagnosis, and sufficient control of inflammation as well as anticoagulant therapy should be performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intestinal Infarction Caused by Thrombophlebitis of the Portomesenteric Veins as a Complication of Acute Gangrenous Appendicitis After Appendectomy

Tang¹,

Tian

Xie³

et al. 2015

Medicine

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Unusual histopathological findings in appendectomy specimens with clinical diagnosis of acute appendicitis: A retrospective cohort analysis

Al-Balas

Al-Saffar

Al-Balas

et al. 2021

Annals of Medicine &Amp; Surgery

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Introduction While appendicitis is considered one of most common acute surgical conditions, several studies have reported abnormal histopathological findings in appendectomy specimens; however, sending all appendices to histopathology is not yet routinely done.Here we report many unusual findings. Those unusual findings played a role not only in confirming acute appendicitis as a cause of the presentation in some cases but also discovering etiologies that mimic it with great impact on its management. Methods Between January 2011 and December 2017, a total of 1510 patients were operated with appendectomy for a primary diagnosis of acute appendicitis. Among them, a total of 72 patients had incidental histopathologic findings in association with acute appendicitis or other pathologies instead of acute appendicitis. A retrospective analysis for those 72 patients was performed with all data being retrieved from the electronic health record system. Results Patients ages ranged between 4 and 71 years with a mean age equal to 23.1 years (SD = 14.2). Majority of patients were women (n = 52; 72.2%). Sixty of the seventy-two cases were seen in patients with negative appendectomies (n = 333) with an overall rate of 18% among this group of patients. The remaining 12 patients had additional findings in histopathology specimens beside acute appendicitis (n = 1131) with an overall rate of 1%. The most commonly reported pathologies were serositis, ovarian cysts, and Enterobius vermicularis in descending frequency. Conclusion Identification of unusual histopathological findings during microscopic examination of resected appendices is more common in female patients and in patients with negative appendectomy. histopathologic assessment of specimens will allow detection of congenital, infectious or malignant pathologies that mimic acute appendicitis clinically even in the absence appendicitis microscopically.

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Mesenteric venous thrombosis as a complication of appendicitis in an adolescent

et al. 2019

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Rationale: Mesenteric venous thrombosis is an uncommon but potentially fatal condition that can cause bowel ischemia. It results from a systemic hypercoagulable state or abdominal infection draining into the portal venous system. Several cases regarding portomesenteric venous thrombosis as a complication of appendicitis were reported in adults, but there are far fewer reports in pediatric patients. The mortality rate of the condition is high if untreated, especially in children, reaching up to 50%. Patient concerns: A healthy 15-year-old male with no significant past medical history presented with right lower quadrant pain, lethargy, and fever. The computed tomography scan showed a focal thrombosis at the superior mesenteric vein branch and an inflamed appendix. Diagnoses: Mesenteric venous thrombosis complicating acute appendicitis. Interventions: Intravenous antibiotics along with anticoagulants and laparoscopic appendectomy Outcomes: After 1 month, a follow-up ultrasonography revealed full resolution of the thrombosis. Lessons: Appendicitis is one of the most frequently encountered causes of pediatric surgical emergencies; therefore, physicians should be conscious of mesenteric venous thrombosis as a possible complication of acute appendicitis, irrespective of whether patients have thrombophilic conditions or not.

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Acute appendicitis with superior mesenteric vein septic thrombophlebitis

Cited by 7 publications

References 9 publications

Intestinal Infarction Caused by Thrombophlebitis of the Portomesenteric Veins as a Complication of Acute Gangrenous Appendicitis After Appendectomy

Intestinal Infarction Caused by Thrombophlebitis of the Portomesenteric Veins as a Complication of Acute Gangrenous Appendicitis After Appendectomy

Unusual histopathological findings in appendectomy specimens with clinical diagnosis of acute appendicitis: A retrospective cohort analysis

Mesenteric venous thrombosis as a complication of appendicitis in an adolescent

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