Pylephlebitis as a complication of acute appendicitis

Castro, Pablo Granero; Rodríguez, Laura Martínez; Gijón, María Moreno; Fernández, Amador Prieto; Trancón, José Granero; González, Juan José; Serra, Luı́s

doi:10.4321/s1130-01082010000300011

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…Articles published in languages other than English; cases where clinical, microbiological, or radiological studies did not support the diagnosis; case reports not providing an adequate amount of information, as well as those reporting non-human subjects were excluded from the analyses. The final number of articles included was 101, which resulted in total number of 103 patients [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ,…”

Section: Methodsmentioning

confidence: 99%

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

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Suppurative portal vein thrombosis (pylephlebitis) is an uncommon condition usually associated with an intra-abdominal infection or inflammatory process. In this study, we aimed to synthesize data on previously published cases according to the PRISMA guidelines. A total of 103 patients were included. Patients were more commonly male (71.8%) and had a mean age of 49 years. The most common infection associated with pylephlebitis was diverticulitis (n = 29, 28.2%), and Escherichia coli was the most isolated pathogen (n = 21, 20.4%). Blood cultures were positive in 64 cases (62.1%). The most common site of thrombosis was the main portal vein (PV) in 59 patients (57.3%), followed by the superior mesenteric vein (SMV) in 40 patients (38.8%) and the right branch of the PV in 30 patients (29.1%). Sepsis developed in 60 patients (58.3%). The mortality rate in our review was 8.7%, and independent risk factors for mortality were the presence of pertinent comorbidities (OR 5.5, p = 0.02), positive blood cultures (OR 2.2, p = 0.02), and sepsis (OR 17.2, p = 0.049).

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Section: Methodsmentioning

confidence: 99%

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Jevtic

Gavrancic

Pantic³

et al. 2022

JCM

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“…The exact role of anticoagulation and duration in the management of septic pylephebitis is controversial. [ 1 2 3 4 ] It prevents thrombus extension, improves recanalization, and reduces the risk of bowel ischemia. The usual recommended period is 4–6 months; however, prolonged anticoagulation may be needed in children with underlying thrombotic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 3 ] The diagnosis relies on clinical features, imaging of the portal system and underlying abdominal pathology, and positive blood/tissue cultures. [ 1 2 3 4 ] Prompt treatment with antibiotics with anticoagulation and surgical management is essential for patient survival. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Complicated Pylephlebitis Secondary to Perforated Appendicitis in an Adolescent

Mehta

Malhotra

Panwar³

et al. 2022

Journal of Indian Association of Pediatric Surgeons

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Septic thrombophlebitis of the portal vein or pylephlebitis is a rare cause of morbidity and mortality in children. The common causes include infective intra-abdominal pathology (acute appendicitis or diverticulitis) or inflammatory conditions (acute pancreatitis and inflammatory bowel disease). Management involves a multidisciplinary team approach for favorable outcome. We present a case report of pylephlebitis secondary to perforated appendicitis with incomplete resolution of thrombosis.

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“…Despite its simple clinical diagnosis, with or without the use of scores, radiological advances and the possibility of a laparoscopic approach, 20-30% of cases of appendicitis are reported to be gangrenous or perforated, due to delays either in requesting help or in the diagnosis itself, with the resulting increase in associated morbidity and mortality. [1][2] Additionally, in relation to subclinical presentation and especially in older patients, up to 10% of patients are diagnosed with an appendiceal mass. Numerous studies have supported an initial conservative therapeutic approach with antibiotics for acute appendicitis with a late onset in the form of an abscess or phlegmon, together with percutaneous drainage if required.…”

Section: Introductionmentioning

confidence: 99%

Surgical Versus Conservative Management of Acute Appendicitis During the Covid-19 Pandemic

Godara

Choudhary

2021

IJMBS

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Background: We aim to analyse the management of patients presenting with AA to our institution during the first wave of the pandemic, comparing surgically and conservatively managed patients Method: Patients were categorised into surgically and conservatively managed groups. The primary outcome was the complication rate (post-operative complications vs failure of antibiotic treatment) and the secondary outcomes were length of hospital stay and Alvarado score. Results: Higher complication rates were observed amongst the conservatively managed group, although not found to be statistically significant (16.67% vs 34.78%; p=>0.05). There was no significant difference in length of hospital stay observed between the two groups (surgical: 2.31±1.02 days vs conservative: 2.62±1.12 days). Conclusions: COVID-19 has led to a significant cohort of conservatively managed AA patients. We propose a stratification pathway based on clinical severity, Alvarado score and imaging to facilitate safe selection for conservative management of AA, in order to reduce failure of treatment rates in this patient group. Keywords: Appendicectomy, Appendicitis, Conservative, Coronavirus

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Pylephlebitis as a complication of acute appendicitis

Cited by 9 publications

References 4 publications

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature

Complicated Pylephlebitis Secondary to Perforated Appendicitis in an Adolescent

Surgical Versus Conservative Management of Acute Appendicitis During the Covid-19 Pandemic

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