Pylephlebitis: Difference between revisions
No edit summary |
Some corrections and additional information added. |
||
| Line 1: | Line 1: | ||
{{Unreferenced|date=November 2006}} |
{{Unreferenced|date=November 2006}} |
||
'''Pylephlebitis''' (also called '''infective suppurative thrombosis of the portal vein''') is an uncommon [[thrombophlebitis]] of the [[portal vein]] or any of its branches. It is usually a complication of intraabdominal sepsis, most often following [[diverticulitis]], perforated [[appendicitis]], or [[peritonitis]]. Considered uniformly lethal in the pre-antibiotic era, it still carries a mortality of 10-30%. It typically presents with fever, rigors, and right upper quadrant abdominal pain, but sometimes abdominal pain may be absent. Liver function test abnormalities are usually present but frank jaundice is uncommon. |
'''Pylephlebitis''' (also called '''infective suppurative thrombosis of the portal vein''') is an uncommon [[thrombophlebitis]] of the [[portal vein]] or any of its branches. It is usually a complication of intraabdominal sepsis, most often following [[diverticulitis]], perforated [[appendicitis]], or [[peritonitis]]. Considered uniformly lethal in the pre-antibiotic era, it still carries a mortality of 10-30%. It typically presents with fever, rigors, and right upper quadrant abdominal pain, but sometimes abdominal pain may be absent. Liver function test abnormalities are usually present but frank jaundice is uncommon. In the modern era, it is usually diagnosed by Computed Tomography of the abdomen and pelvis. Bacteriology is often polymicrobial and blood cultures are positive in some cases. A significant fraction of people presenting with this condition have an underlying hyper-coagulable state. Treatment is with a prolonged course of broad-spectrum antibiotics, with the addition of anticoagulants if other clots are present outside the portal vein or if fever persists on antibiotic therapy. |
||
Once diagnosed the infection is treated by administering common [[antibiotics]] which will end the [[sepsis]]. |
Once diagnosed the infection is treated by administering common [[antibiotics]] which will end the [[sepsis]]. |
||
Revision as of 20:25, 5 May 2014
 |
Pylephlebitis (also called infective suppurative thrombosis of the portal vein) is an uncommon thrombophlebitis of the portal vein or any of its branches. It is usually a complication of intraabdominal sepsis, most often following diverticulitis, perforated appendicitis, or peritonitis. Considered uniformly lethal in the pre-antibiotic era, it still carries a mortality of 10-30%. It typically presents with fever, rigors, and right upper quadrant abdominal pain, but sometimes abdominal pain may be absent. Liver function test abnormalities are usually present but frank jaundice is uncommon. In the modern era, it is usually diagnosed by Computed Tomography of the abdomen and pelvis. Bacteriology is often polymicrobial and blood cultures are positive in some cases. A significant fraction of people presenting with this condition have an underlying hyper-coagulable state. Treatment is with a prolonged course of broad-spectrum antibiotics, with the addition of anticoagulants if other clots are present outside the portal vein or if fever persists on antibiotic therapy.
Once diagnosed the infection is treated by administering common antibiotics which will end the sepsis.
It is a cause of portal hypertension.
References
- The American Journal of Gastroenterology 96, 1312–1313 (1 April 2001) | doi:10.1111/j.1572-0241.2001.03736.x
 | This article about a disease, disorder, or medical condition is a stub. You can help Wikipedia by expanding it. |