Abstract
We report the imaging findings and management of a case of suppurative pylephlebitis of unknown cause in a 10-year-old girl. Percutaneous aspiration of frank pus from the portal vein confirmed the diagnosis and contributed to therapy. Percutaneous transhepatic thrombolysis was attempted but was unsuccessful. Because of the nonspecific presentation of this condition and the lack of familiarity of physicians with this entity, the diagnosis is often delayed. Our aim is to increase the awareness of this entity and stress the importance of early diagnosis and appropriate therapy.
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Plemmons RM, Dooley DP, Longfield RN (1995) Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis 21:1114–1120
Baril N, Wren S, Radin R, Ralls P, Stain S (1996) The role of anticoagulation in pylephlebitis. Am J Surg 172:449–453
Condat B, Pessione F, Helene Denninger M, Hillaire S, Valla D (2000) Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology 32:466–470
Farin P, Paajanen H, Miettinen P (1997) Intraoperative US diagnosis of pylephlebitis (portal vein thrombosis) as a complication of appendicitis: a case report. Abdom Imaging 22:401–403
Nouira K, Bedioui H, Azaiez O, Belhiba H, Ben Messaoud M, Ksantini R, Jouini M, Menif E (2007) Percutaneous drainage of suppurative pylephlebitis complicating acute pancreatitis. CardioVasc Interv Radiol 30:1242–1244
Nishimori H, Ezoe E, Ura H, Imaizumi H, Meguro M, Furuhata T, Katsuramaki T, Hata F, Yasoshima T, Hirata K, Asai Y (2004) Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case. Surg Today 34:173–176
Watanabe H, Muguruma T, Idoguchi K, Matsuoka T (2007) Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis. J Gastroenterol 42:589–592
Dotter CT (1979) Selective fibrinolysis for acute portal vein thrombosis in infants. Pediatrics 63:504
Schafer C, Zundler J, Bode JC (2000) Thrombolytic therapy in patients with portal vein thrombosis: case report and review of the literature. Eur J Gastroenterol Hepatol 12:1141–1145
Sherigar R, Amir KA, Bobba RK, Arsura EL, Srinivas N (2005) Abdominal pain secondary to pylephlebitis:an uncommon disease of the portal venous system, treated with local thrombolytic therapy. Dig Dis Sci 50:983–987
Aytekin C, Boyvat F, Kurt A, Yologlu Z, Coskun M (2001) Catheter-directed thrombolysis with transjugular access in portal vein thrombosis secondary to pancreatitis. Eur J Radiol 39:80–82
Lopera JE, Correa G, Brazzini A, Ustunsoz B, Patel S, Janchai A, Castaneda-Zuniga W (2002) Percutaneous transhepatic treatment of symptomatic mesenteric venous thrombosis. J Vasc Surg 36:1058–1061
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Bogue, C.O., Leahy, T.R., Rea, D.J. et al. Idiopathic Suppurative Pylephlebitis: Interventional Radiological Diagnosis and Management. Cardiovasc Intervent Radiol 32, 1304–1307 (2009). https://doi.org/10.1007/s00270-009-9586-7
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DOI: https://doi.org/10.1007/s00270-009-9586-7