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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Pylephlebitis in pediatrics: A diagnostic challenge.

Dolores Artese1, Juana I Romero1, Natalia P Álvarez1

  • 1Hospital Nacional de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, City of Buenos Aires, Argentina.

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Summary
This summary is machine-generated.

Pylephlebitis, a serious portal vein complication from abdominal infections like appendicitis, requires prompt diagnosis via imaging. Early treatment improves outcomes, but cavernomatous transformation necessitates long-term monitoring for liver failure.

Keywords:
appendicitispediatricsportal veinthrombophlebitis

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Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Pylephlebitis is defined as suppurative thrombosis of the portal vein, often stemming from abdominal infections.
  • In pediatric cases, acute appendicitis is the most common cause, frequently presenting late as sepsis with high mortality.

Observation:

  • This case highlights pylephlebitis secondary to Escherichia coli sepsis originating from acute appendicitis in a pediatric patient.
  • The patient progressed to cavernomatous transformation of the portal vein, a significant complication.

Findings:

  • Diagnosis relies on imaging, primarily Doppler ultrasound and computed tomography angiography.
  • Treatment involves surgery, antibiotics, and potentially anticoagulation, though its use remains debated.

Implications:

  • Effective management is crucial, as patients require close follow-up post-initial treatment to monitor for potential progression to liver failure.
  • Understanding and timely intervention in pediatric pylephlebitis can mitigate severe morbidity and mortality.