Complicated Pylephlebitis Secondary to Perforated Appendicitis in an Adolescent

Mehta, Sagar Jayesh; Malhotra, Smita; Panwar, Amrish K.; Sibal, Anupam

doi:10.4103/jiaps.jiaps_291_20

Cited by 5 publications

(9 citation statements)

References 6 publications

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“…Pylephlebitis can be defined as the thrombophlebitis of the portal vein and its tributaries. Appendicitis leading to pylephlebitis in children is uncommon but a life threatening complication [ 4 ]. Other abdominal infections draining to portal vein can lead to pylephlebitis [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many case reports and series published in the literature mention use of anticoagulants. It may prevent thrombus extension, improve recanalization and reduce the risk of bowel ischemia [ 4 ]. Anticoagulants may be recommended in the background of hypercoagulable states or mesenteric vein thrombosis to prevent bowel ischemia [ 11 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence in children is unknown as it is rare but adult studies show an incidence of 2.7 per 100000 person-year [ 4 ]. Though uncommon, undiagnosed perforated appendicitis in children may lead to pylephlebitis and only few cases have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Early antibiotics administration and surgical intervention has decreased the incidence to 0.05% for acute appendicitis and 3% for ruptured appendicitis [ 6 ]. The mortality rate of this life threatening condition in children have been reported to be up to 50% [ 4 ]. Diagnosis may be elusive and delayed due to non-specific presentation and requires a high index of suspicion in the background of an abdominal sepsis.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report

Pahari

Shrestha²,

Basukala

et al. 2022

Annals of Medicine &Amp; Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report

Pahari

Shrestha²,

Basukala

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Los síntomas informados con más frecuencia al ingreso fueron fiebre (79%) y dolor abdominal (62%) (Bezerra et al, 2021;Mehta et al, 2022). En una serie de casos de 44 pacientes, todos informaron estos dos síntomas (Abdallah et al, 2020;Choudhry et al, 2018).…”

Section: Manifestación Clínicaunclassified

Manejo de la pileflebitis como complicación post apendicectomía

Jordán Oña,

Loaiza Merino

2024

rgn

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La pileflebitis es una complicación rara pero grave, asociada a riesgos como abscesos hepáticos, sepsis, e insuficiencia hepática aguda que repercute como trombosis de la vena porta post-apendicectomía. Por ello el objetivo del estudio fue evaluar la efectividad de los protocolos de atención y manejo para la pileflebitis post-apendicectomía, con el fin de identificar las mejores prácticas clínicas y mejorar el cuidado de los pacientes. Se realizó una revisión sistemática de literatura científica, aplicando un muestreo no probabilístico por conveniencia. Se seleccionaron 40 trabajos científicos publicados entre 2018 y 2023, utilizando bases de datos como PubMed/Medline, Elsevier Scopus, Science Direct, y Taylor & Francis. Los resultados revelaron que la pileflebitis post-apendicectomía presenta una incidencia baja, que afecta predominantemente a hombres, con síntomas como fiebre y dolor abdominal. Las causas más frecuentes son la diverticulitis y la apendicitis aguda. El tratamiento preferido incluye antibióticos de amplio espectro y, en algunos casos, anticoagulantes. La investigación sugiere la necesidad de protocolos de atención estandarizados para optimizar el manejo de esta complicación.

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Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosis

et al. 2023

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Pylephlebitis, defined as infective thrombophlebitis of the portal vein, is a rare condition with an incidence of 0.37–2.7 cases per 100,000 person-years, which can virtually complicate any intra-abdominal or pelvic infections that develop within areas drained by the portal venous circulation. The current systematic review aimed to investigate the etiology behind pylephlebitis in terms of pathogens involved and causative infective processes, and to report the most common symptoms at clinical presentation. We included 220 individuals derived from published cases between 1971 and 2022. Of these, 155 (70.5%) were male with a median age of 50 years. There were 27 (12.3%) patients under 18 years of age, 6 (2.7%) individuals younger than one year, and the youngest reported case was only 20 days old. The most frequently reported symptoms on admission were fever (75.5%) and abdominal pain (66.4%), with diverticulitis (26.5%) and acute appendicitis (22%) being the two most common causes. Pylephlebitis was caused by a single pathogen in 94 (42.8%) cases and polymicrobial in 60 (27.2%) cases. However, the responsible pathogen was not identified or not reported in 30% of the included patients. The most frequently isolated bacteria were Escherichia coli (25%), Bacteroides spp. (17%), and Streptococcus spp. (15%). The treatment of pylephlebitis consists initially of broad-spectrum antibiotics that should be tailored upon bacterial identification and continued for at least four to six weeks after symptom presentation. There is no recommendation for prescribing anticoagulants to all patients with pylephlebitis. However, they should be administered in patients with thrombosis progression on repeat imaging or persistent fever despite proper antibiotic therapy to increase the rates of thrombus resolution or decrease the overall mortality, which is approximately 14%.

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Complicated Pylephlebitis Secondary to Perforated Appendicitis in an Adolescent

Cited by 5 publications

References 6 publications

Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report

Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report

Manejo de la pileflebitis como complicación post apendicectomía

Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosis

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