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Acute appendicitis with superior mesenteric vein septic thrombophlebitis
Pi-Kai Chang1, Kuo-Feng Hsu, Jyh-Cherng Yu
1Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Summary
Septic thrombophlebitis of the superior mesenteric vein (SMV), a rare complication of appendicitis, can be successfully treated. Early diagnosis and combined surgical, antibiotic, and anticoagulation therapy resolved SMV thrombosis.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Infectious Diseases
Background:
- Septic thrombophlebitis of the superior mesenteric vein (SMV) is a rare but serious condition.
- Acute appendicitis is an uncommon cause of SMV septic thrombophlebitis.
- Delayed diagnosis due to varied and atypical symptoms contributes to high mortality rates (30-50%).
Observation:
- A case of SMV septic thrombophlebitis secondary to acute appendicitis is presented.
- The patient exhibited atypical clinical symptoms, leading to a diagnostic delay.
Findings:
- Successful treatment was achieved through a combination of surgical intervention, targeted antibiotic therapy, and anticoagulation.
- Follow-up imaging (abdominal CT scan) at 3 months confirmed complete resolution of the SMV thrombosis.
Implications:
- This case highlights the importance of considering SMV septic thrombophlebitis in appendicitis patients with atypical presentations.
- Aggressive, multi-modal treatment can lead to favorable outcomes in this challenging condition.
- Further research may elucidate optimal diagnostic and therapeutic strategies for SMV septic thrombophlebitis originating from appendicitis.
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