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Isolated superior mesenteric venous thrombophlebitis with acute appendicitis

Mohsen Mohamed Karam1, Mohaed Fahmy Abdalla, Said Bedair

  • 1Hamad Medical Corporation, G Surgery, 46 Teba Garden, Doha, Qatar.

International Journal of Surgery Case Reports
|March 19, 2013
PubMed
Abstract

Insights

Superior mesenteric venous thrombophlebitis, a rare condition, can be effectively treated with appendectomy, antibiotics, and anticoagulation. Early diagnosis via imaging is crucial for successful outcomes in atypical abdominal pain cases.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Radiology

Background:

  • Isolated superior mesenteric venous thrombophlebitis is a rare but high-morbidity condition.
  • It often arises secondary to infections within the portal venous system, such as appendicitis.

Purpose of the Study:

  • To report a case of neglected perforated acute appendicitis complicated by superior mesenteric venous pyelephlebitis.
  • To highlight the diagnostic and therapeutic approach for this rare condition.

Main Methods:

  • A case of atypical abdominal pain was investigated using computed tomography (CT) scan.
  • Treatment involved appendectomy, broad-spectrum antibiotics, and anticoagulation.

Main Results:

  • CT scan revealed an obstructed superior mesenteric vein with acute appendicitis.
  • The patient achieved full recovery with complete canalization of the superior mesenteric vein after one month of treatment.
  • Imaging confirmed the successful resolution of the thrombophlebitis.

Conclusions:

  • Atypical abdominal pain warrants prompt imaging for diagnosis.
  • CT scan is vital for early detection and assessment of pylephlebitis extent.
  • Prompt treatment, including source control and anticoagulation, is essential to prevent complications.

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