Pylephlebitis complicating acute calculous cholecystitis: A case report

Pylephlebitis – an uncommon challenging entity

“…Pylephlebitis, or thrombophlebitis of the portal vein system, is an infrequent condition mainly associated with Gram-negative bacteria, 1 - 5 which has been related to the origin of liver abscesses since almost three centuries ago; 1 , 4 with an estimated prevalence of 7%, 2 and an incidence that ranges from 0.3 to 3 cases per 100,000 patients per year. 1 , 4 Pancreatitis, diverticulitis, peritonitis, appendicitis, and cholecystitis are the major associated entities.…”

“… 1 After a long-standing follow-up, he maintained normal liver function and nutritional status; the authors stressed the importance of early diagnosis in the prevention of irreversible complications. 1 Faye et al 2 reported a 43-year-old female presenting fever, abdominal pain, vomiting, leukocytosis, high C-reactive protein, and inflamed distended gallbladder with lithiasis; besides evidence of pylephlebitis at the portal trunk and the right portal branch. After the hospital admission, she underwent ceftriaxone and metronidazole with a good response and was discharged on day 7, already with a scheduled cholecystectomy.…”

“…After the hospital admission, she underwent ceftriaxone and metronidazole with a good response and was discharged on day 7, already with a scheduled cholecystectomy. 2 The authors highlighted the challenging clinical manifestations and the useful role of tomography images in confirming the diagnosis and clearly identifying associated etiological factors. 2 Hapshy et al 3 described a 42-year-old man with fever, acute abdominal pain, jaundice, mental changes, tachycardia, and arterial hypotension, besides leukocytosis.…”

“… 2 The authors highlighted the challenging clinical manifestations and the useful role of tomography images in confirming the diagnosis and clearly identifying associated etiological factors. 2 Hapshy et al 3 described a 42-year-old man with fever, acute abdominal pain, jaundice, mental changes, tachycardia, and arterial hypotension, besides leukocytosis. However, the abdominal and chest imaging studies did not detect the infection site; blood cultures revealed the presence of Fusobacterium necrophorum and Bacteroides ovatus .…”