A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation

Appendicitis; Cholangitis presentation; Phylephlebitis

Detalhes bibliográficos
Autores: Dalmau Romero, Mar, Lopez, Pablo, Vilallonga Puy, Ramón, Garcia Ruiz de Gordejuela, Amador, Petrola Chacón, Carlos, Armengol Carrasco, Manuel
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2022
País:España
Recursos:Departament de Salut de la Generalitat de Catalunya (DS)
Repositório:Scientia. Dipòsit d'Informació Digital del Departament de Salut
OAI Identifier:oai:scientiasalut.gencat.cat:11351/8675
Acesso em linha:https://hdl.handle.net/11351/8675
Access Level:Acceso aberto
Palavra-chave:Apendicitis - Compliacions
Tromboflebitis - Diagnòstic
DISEASES::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections::Appendicitis
Other subheadings::Other subheadings::Other subheadings::/complications
DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis::Thrombophlebitis
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones intraabdominales::apendicitis
Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones
ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa::tromboflebitis
id ES_6cefd5d5d78fba47e7ace3ff8a37ec80
oai_identifier_str oai:scientiasalut.gencat.cat:11351/8675
network_acronym_str ES
network_name_str España
repository_id_str
spelling A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situationDalmau Romero, MarLopez, PabloVilallonga Puy, RamónGarcia Ruiz de Gordejuela, AmadorPetrola Chacón, CarlosArmengol Carrasco, ManuelApendicitis - CompliacionsTromboflebitis - DiagnòsticDISEASES::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections::AppendicitisOther subheadings::Other subheadings::Other subheadings::/complicationsDISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis::ThrombophlebitisENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones intraabdominales::apendicitisOtros calificadores::Otros calificadores::Otros calificadores::/complicacionesENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa::tromboflebitisAppendicitis; Cholangitis presentation; PhylephlebitisApendicitis; Presentación de colangitis; PileflebitisApendicitis; Presentació de colangitis; PileflebitisIntroduction Pylephlebitis represents an uncommon but serious condition with significant mortality which can complicate intrabdominal sepsis of any etiology. One of the most common predisposing infections is appendicitis. Presentation of case A 21-year-old male with 4 days of epigastric and right upper quadrant pain with associated fever and chills with hyperbilirubinemia and leukocytosis in blood test was orientated as cholangitis at first diagnostic. Poor response to antibiotic treatment with persistent fever and bacteriemia with E. coli and S. constellatus isolated in blood cultures led to complete the study with a CT scan which revealed an acute appendicitis complicated with thrombosis of the superior mesenteric vein (SMV) up to the splenoportal confluence. Appendectomy, treatment with broad-spectrum antibiotic and anticoagulation treatment led to full recovery. Follow-up after 6 months showed almost complete SMV patency. Discussion Pylephlebitis can present as a clinical cholangitis-like picture with hyperbilirubinemia with or without liver abscess formation. CT scan seems to be the most sensitive diagnostic test as it identifies the underlying focus of infection, the extension of the thrombosis and detects liver abscesses. Surgical removal of the source of infection as appendectomy and adequate antibiotic treatment adjusted by culture should be initiated promptly. Anticoagulant treatment should be considered in the case of poor clinical outcome or thrombosis progression. Conclusion Pylephlebitis should be suspected mainly in patients with appendicitis and diverticulitis with erratic behavior despite surgical removal and/or antibiotic treatment with abnormal liver tests and persistent bacteriemia. CT scan is the preferred image study.ElsevierInstitut Català de la Salut[Dalmau M, Petrola C, Lopez P] Unitat Docent de Cirurgia General i Aparell Digestiu, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Vilallonga R, Garcia Ruiz de Gordejuela A, Armengol M] Unitat Docent de Cirurgia General i Aparell Digestiu, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, SpainVall d'Hebron Barcelona Hospital Campus202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/11351/8675Scientiareponame:Scientia. Dipòsit d'Informació Digital del Departament de Salutinstname:Departament de Salut de la Generalitat de Catalunya (DS)InglésInternational Journal of Surgery Case Reports;99https://doi.org/10.1016/j.ijscr.2022.107657Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:scientiasalut.gencat.cat:11351/86752026-06-12T09:38:37Z
dc.title.none.fl_str_mv A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
title A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
spellingShingle A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
Dalmau Romero, Mar
Apendicitis - Compliacions
Tromboflebitis - Diagnòstic
DISEASES::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections::Appendicitis
Other subheadings::Other subheadings::Other subheadings::/complications
DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis::Thrombophlebitis
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones intraabdominales::apendicitis
Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones
ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa::tromboflebitis
title_short A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
title_full A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
title_fullStr A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
title_full_unstemmed A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
title_sort A case of pylephlebitis complicating an acute appendicitis: Uncommon cholangitis-like situation
dc.creator.none.fl_str_mv Dalmau Romero, Mar
Lopez, Pablo
Vilallonga Puy, Ramón
Garcia Ruiz de Gordejuela, Amador
Petrola Chacón, Carlos
Armengol Carrasco, Manuel
author Dalmau Romero, Mar
author_facet Dalmau Romero, Mar
Lopez, Pablo
Vilallonga Puy, Ramón
Garcia Ruiz de Gordejuela, Amador
Petrola Chacón, Carlos
Armengol Carrasco, Manuel
author_role author
author2 Lopez, Pablo
Vilallonga Puy, Ramón
Garcia Ruiz de Gordejuela, Amador
Petrola Chacón, Carlos
Armengol Carrasco, Manuel
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Institut Català de la Salut
[Dalmau M, Petrola C, Lopez P] Unitat Docent de Cirurgia General i Aparell Digestiu, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Vilallonga R, Garcia Ruiz de Gordejuela A, Armengol M] Unitat Docent de Cirurgia General i Aparell Digestiu, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
dc.subject.none.fl_str_mv Apendicitis - Compliacions
Tromboflebitis - Diagnòstic
DISEASES::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections::Appendicitis
Other subheadings::Other subheadings::Other subheadings::/complications
DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis::Thrombophlebitis
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones intraabdominales::apendicitis
Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones
ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa::tromboflebitis
topic Apendicitis - Compliacions
Tromboflebitis - Diagnòstic
DISEASES::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections::Appendicitis
Other subheadings::Other subheadings::Other subheadings::/complications
DISEASES::Cardiovascular Diseases::Vascular Diseases::Embolism and Thrombosis::Thrombosis::Venous Thrombosis::Thrombophlebitis
ENFERMEDADES::infecciones bacterianas y micosis::infección::infecciones intraabdominales::apendicitis
Otros calificadores::Otros calificadores::Otros calificadores::/complicaciones
ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::embolia y trombosis::trombosis::trombosis venosa::tromboflebitis
description Appendicitis; Cholangitis presentation; Phylephlebitis
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11351/8675
url https://hdl.handle.net/11351/8675
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International Journal of Surgery Case Reports;99
https://doi.org/10.1016/j.ijscr.2022.107657
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv Scientia
reponame:Scientia. Dipòsit d'Informació Digital del Departament de Salut
instname:Departament de Salut de la Generalitat de Catalunya (DS)
instname_str Departament de Salut de la Generalitat de Catalunya (DS)
reponame_str Scientia. Dipòsit d'Informació Digital del Departament de Salut
collection Scientia. Dipòsit d'Informació Digital del Departament de Salut
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869410304025165824
score 15,812429

Registros relacionados