Cargando…
Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report
INTRODUCTION AND IMPORTANCE: Pylephlebitis is a rare and life threatening thrombophlebitis of the portal vein. It commonly occurs following intra abdominal infections like appendicitis. It is even rarer in the pediatric age group. The nonspecific presentation impedes the diagnosis. Timely use of app...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577868/ https://www.ncbi.nlm.nih.gov/pubmed/36268367 http://dx.doi.org/10.1016/j.amsu.2022.104744 |
_version_ | 1784811854021787648 |
---|---|
author | Pahari, Soumya Shrestha, Manju Basukala, Sunil Kafle, Pooja Rai, Kalpana Khand, Yugant Thapa, Ojas Thapa, Anup |
author_facet | Pahari, Soumya Shrestha, Manju Basukala, Sunil Kafle, Pooja Rai, Kalpana Khand, Yugant Thapa, Ojas Thapa, Anup |
author_sort | Pahari, Soumya |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Pylephlebitis is a rare and life threatening thrombophlebitis of the portal vein. It commonly occurs following intra abdominal infections like appendicitis. It is even rarer in the pediatric age group. The nonspecific presentation impedes the diagnosis. Timely use of appropriate antibiotics and control of infection is paramount in its treatment and this case report highlights the same. CASE PRESENTATION: 11 year old female child from a rural area was referred from a local hospital for persistent fever and abdominal pain despite medical treatment. Workup revealed perforated appendicitis, pylephlebitis, and multiple liver abscess. She was successfully treated with appendicectomy followed by antibiotics and anticoagulants. CLINICAL DISCUSSION: Pylephlebitis secondary to appendicitis was frequently lethal in the pre-antibiotic era. Doppler ultrasonography and CT scan are the investigations of choice to establish the diagnosis by showing a thrombus in the portal vein. With use of antibiotics, early diagnosis by imaging and surgical control of the primary infection, appendicitis-associated-pylephlebitis now has improved outcomes. Larger scale studies are required to establish the role of anticoagulants. CONCLUSION: Early diagnosis and intervention of this fatal condition is life saving but numerous gaps exist in the literature regarding the treatment recommendation. |
format | Online Article Text |
id | pubmed-9577868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-95778682022-10-19 Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report Pahari, Soumya Shrestha, Manju Basukala, Sunil Kafle, Pooja Rai, Kalpana Khand, Yugant Thapa, Ojas Thapa, Anup Ann Med Surg (Lond) Case Report INTRODUCTION AND IMPORTANCE: Pylephlebitis is a rare and life threatening thrombophlebitis of the portal vein. It commonly occurs following intra abdominal infections like appendicitis. It is even rarer in the pediatric age group. The nonspecific presentation impedes the diagnosis. Timely use of appropriate antibiotics and control of infection is paramount in its treatment and this case report highlights the same. CASE PRESENTATION: 11 year old female child from a rural area was referred from a local hospital for persistent fever and abdominal pain despite medical treatment. Workup revealed perforated appendicitis, pylephlebitis, and multiple liver abscess. She was successfully treated with appendicectomy followed by antibiotics and anticoagulants. CLINICAL DISCUSSION: Pylephlebitis secondary to appendicitis was frequently lethal in the pre-antibiotic era. Doppler ultrasonography and CT scan are the investigations of choice to establish the diagnosis by showing a thrombus in the portal vein. With use of antibiotics, early diagnosis by imaging and surgical control of the primary infection, appendicitis-associated-pylephlebitis now has improved outcomes. Larger scale studies are required to establish the role of anticoagulants. CONCLUSION: Early diagnosis and intervention of this fatal condition is life saving but numerous gaps exist in the literature regarding the treatment recommendation. Elsevier 2022-09-23 /pmc/articles/PMC9577868/ /pubmed/36268367 http://dx.doi.org/10.1016/j.amsu.2022.104744 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Pahari, Soumya Shrestha, Manju Basukala, Sunil Kafle, Pooja Rai, Kalpana Khand, Yugant Thapa, Ojas Thapa, Anup Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title | Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title_full | Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title_fullStr | Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title_full_unstemmed | Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title_short | Complicated pylephlebitis secondary to perforated appendicitis in a child- A rare case report |
title_sort | complicated pylephlebitis secondary to perforated appendicitis in a child- a rare case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577868/ https://www.ncbi.nlm.nih.gov/pubmed/36268367 http://dx.doi.org/10.1016/j.amsu.2022.104744 |
work_keys_str_mv | AT paharisoumya complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT shresthamanju complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT basukalasunil complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT kaflepooja complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT raikalpana complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT khandyugant complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT thapaojas complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport AT thapaanup complicatedpylephlebitissecondarytoperforatedappendicitisinachildararecasereport |