[Pylephlebitis related to acute appendicitis. Case and review]

Area of Science:

• Gastroenterology
• Vascular Surgery
• Infectious Diseases

Background:

• Pylephlebitis is septic thrombophlebitis of the portal venous system.
• It can range from asymptomatic to severe complications, including septic shock and hepatic failure.

Observation:

• A 24-year-old male presented with fever, jaundice, and choluria post-appendectomy.
• Intravenous contrast CT revealed thrombus in the portal, splenic, and mesenteric veins, confirming pylephlebitis.

Findings:

• Pylephlebitis incidence is approximately 2.7 cases per year.
• Fever and abdominal pain occur in over 80% of cases.
• Intravenous contrast CT is the gold standard for diagnosis.

Implications:

• Pylephlebitis must be considered a complication of intra-abdominal infections.
• Timely diagnosis and treatment (antibiotics, anticoagulation, septic focus control) reduce morbidity and mortality.