Tromboflebitis séptica de la vena porta (pileflebitis): diagnóstico y manejo a propósito de tres casos

Abstract

We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment.

Acute Diverticulitis Presenting as a Pylephlebitis: Case Report

“…The infective process affects the endothelium originating thrombosis than migrate through portal drainage and affect its territory, and its intrahepatic branches being able, if untreated, to originate hepatic abscesses, septic shock, hepatic dis-function, progression of the thrombosis to the mesenteric territory, secondary intestinal ischemia,etc. [1,2].The most frequent cause reported is diverticulitis (30%), followed by appendicitis (19%), inflammatory bower disease, pancreatitis, and others [1].In this case, the cause was initially suspected to be an intra-abdominal sepsis located in the sigma, with secondary suspicion after colonoscopy of a focal diverticulitis.The symptoms are totally unspecific being the more common ones, fever (86%) and abdominal pain (82%).…”

“…It is also frequently accompanied of bacteraemia, with blood cultures positive in a high percentage (up to 80% in some series) [1,2].…”

“…It is recommended if the thrombosis extends to mesenteric territory, there is an hypercoagulation state, an infection from Bacteroides spp. is detected, thrombosis progression appears in successive controls or there is persistence of the fever or clinical signs of infection [1][2][3][4][5][6][7][8]. There are studies, in which early anticoagulation translates into a more rapid recanalization of the clot and less fatal events [1,8].…”