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Pylephlebitis, portal-mesenteric thrombosis, and multiple liver abscesses owing to perforated appendicitis

T N Chang1, L Tang, K Keller

  • 1Departments of Surgery and Radiology, University of California, San Francisco, CA 94143-0570, USA.

Insights

A ruptured appendix led to severe complications including pylephlebitis, portal-mesenteric thrombosis, and liver abscesses in a child. This rare case highlights the critical need for prompt appendicitis treatment to prevent life-threatening outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Infectious Diseases

Background:

  • Appendicitis is a common surgical emergency in children.
  • Complicated appendicitis can lead to serious intra-abdominal infections and vascular complications.

Observation:

  • An 8-year-old boy presented with a ruptured retrocecal appendix.
  • The patient exhibited pylephlebitis, portal-mesenteric thrombosis, and multiple liver abscesses.

Findings:

  • Surgical intervention included a right hemicolectomy and drainage of liver abscesses.
  • The patient received prolonged antibiotic therapy and anticoagulation.
  • This represents a unique documented case of perforated appendicitis with these three specific severe complications.

Implications:

  • This case underscores the potential for severe vascular and infectious sequelae from perforated appendicitis.
  • Early diagnosis and management are crucial to prevent catastrophic outcomes in pediatric appendicitis.
  • Highlights the importance of considering rare but severe complications in pediatric surgical cases.

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