Case: A 59-year-old Asian man presented to our emergency department with hypogastrium pain, loss of appetite, and diarrhea. On admission, he was hypotensive and jaundiced. Laboratory test results revealed thrombocytopenia, hypercreatininemia, and hyperbilirubinemia. Color Doppler sonography showed no blood flow in the right and left branches of the portal vein, which seemed similar to biliary obstruction. Enhanced computed tomography showed portal vein thrombi, consistent with pylephlebitis; a broad-spectrum antibiotic and an anticoagulant were administered. Outcome: The patient died of multiple organ failure 22 h post-admission. An autopsy revealed suppurative thrombi in the portal vein, multiple liver abscesses, and diverticulitis in the sigmoid colon. Conclusion: Pylephlebitis, a rare complication of intra-abdominal infections, is associated with high rates of morbidity and mortality. Ultrasonography findings mimic those of biliary obstruction. Enhanced computed tomography is useful for diagnosing this condition.
Case: A 59-year-old Asian man presented to our emergency department with hypogastrium pain, loss of appetite, and diarrhea. On admission, he was hypotensive and jaundiced. Laboratory test results revealed thrombocytopenia, hypercreatininemia, and hyperbilirubinemia. Color Doppler sonography showed no blood flow in the right and left branches of the portal vein, which seemed similar to biliary obstruction. Enhanced computed tomography showed portal vein thrombi, consistent with pylephlebitis; a broad-spectrum antibiotic and an anticoagulant were administered. Outcome: The patient died of multiple organ failure 22 h post-admission. An autopsy revealed suppurative thrombi in the portal vein, multiple liver abscesses, and diverticulitis in the sigmoid colon. Conclusion: Pylephlebitis, a rare complication of intra-abdominal infections, is associated with high rates of morbidity and mortality. Ultrasonography findings mimic those of biliary obstruction. Enhanced computed tomography is useful for diagnosing this condition.
Authors: Andrés de Roux; Manuela Cavalcanti; Maria Angeles Marcos; Elisa Garcia; Santiago Ewig; José Mensa; Antoni Torres Journal: Chest Date: 2006-05 Impact factor: 9.410
Authors: Dorde Jevtic; Tatjana Gavrancic; Ivana Pantic; Terri Nordin; Charles W Nordstrom; Marina Antic; Nikola Pantic; Marija Kaljevic; Bojan Joksimovic; Milan Jovanovic; Emilia Petcu; Mladen Jecmenica; Tamara Milovanovic; Lawrence Sprecher; Igor Dumic Journal: J Clin Med Date: 2022-08-25 Impact factor: 4.964