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Pylephlebitis associated with appendicitis.

H E Lim1, H J Cheong, H J Woo

  • 1Department of Internal Medicine, Korea University, Seoul, Korea.

The Korean Journal of Internal Medicine
|March 4, 1999
PubMed
Summary
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Pylephlebitis, a serious portal vein infection, often stems from diverticulitis. Prompt antibiotic treatment, even for severe sepsis, is crucial for patient recovery and survival.

Area of Science:

  • Internal Medicine
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Pylephlebitis is septic thrombophlebitis of the portal venous system.
  • It typically arises secondary to intra-abdominal infections.
  • Common preceding infections include diverticulitis and appendicitis.

Observation:

  • A case of pylephlebitis secondary to appendicitis is presented.
  • The condition involved septic thrombosis of the portal vein and its branches.
  • Infection disseminated to the liver, forming abscesses.

Findings:

  • Escherichia coli (54%) and Proteus mirabilis (23%) are the most common causative organisms.
  • Overall mortality for pylephlebitis is 32%.
  • Patients who died often had severe sepsis before antibiotic initiation.

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Implications:

  • This case highlights the importance of early diagnosis and prompt antibiotic therapy for pylephlebitis.
  • Timely intervention can lead to complete resolution and a favorable clinical outcome.
  • Appendicitis should be considered as a potential source of pylephlebitis.