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Pylephlebitis and Hepatic Abscess Secondary to Complicated Appendicitis in a Geriatric Patient With Undiagnosed Situs
Christian Ballardo Medina1, Mariana Burgueño Ibarra1, Paul Humberto Valdez Castillejo1
1General Surgery, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) Universidad Autónoma de Sinaloa (UAS), Culiacán, MEX.
Abstract:
Pylephlebitis is an uncommon but severe complication of intra-abdominal infections, particularly associated with conditions such as appendicitis or diverticulitis. Although it is more frequently observed in older men, it can occur in other age groups and carries significant mortality if not diagnosed in a timely manner. Acute appendicitis remains the leading cause of emergency abdominal surgery worldwide, with a higher risk of complications in elderly patients due to diagnostic challenges. Situs inversus totalis, an unusual anatomical condition, may delay diagnosis by altering the clinical location of symptoms. We report the case of a geriatric patient with previously undiagnosed situs inversus totalis who developed complicated appendicitis with pylephlebitis and hepatic abscess, highlighting the clinical and therapeutic challenges of this combination.
Insights
This case report details a rare instance of complicated appendicitis with pylephlebitis and hepatic abscess in an elderly patient with situs inversus totalis. The unusual anatomy presented diagnostic and therapeutic challenges.
Area of Science:
- Medicine
- Surgery
- Radiology
Background:
- Pylephlebitis is a rare but severe complication of intra-abdominal infections, often linked to appendicitis or diverticulitis.
- Acute appendicitis is a leading cause of emergency abdominal surgery, with increased risks in elderly patients.
- Situs inversus totalis is a rare anatomical anomaly where major visceral organs are reversed, potentially complicating diagnosis.
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