PDF(Pubmed)
Abstract：
BACKGROUND: Pylephlebitis is an extremely rare form of septic thrombophlebitis involving the portal vein, carrying high rates of morbidity and mortality.
METHODS: We present a case of a 42-year-old male with no past medical history who presented with acute onset of abdominal pain and altered mental status with laboratory tests demonstrating new-onset acute liver failure. Pylephlebitis was determined to be the underlying etiology due to subsequent workup revealing polymicrobial gram-negative anaerobic bacteremia and complete thrombosis of the main and left portal veins. To our knowledge, this is the first documented case of acute liver failure as a potential life-threatening complication of pylephlebitis.
CONCLUSIONS: Our case highlights the importance of considering pylephlebitis in the broad differential for abdominal pain, especially if there are co-existing risk factors for hypercoagulability. We also demonstrate that fulminant hepatic failure in these patients can potentially be reversible with the immediate initiation of antibiotics and anticoagulation.
METHODS: We present a case of a 42-year-old male with no past medical history who presented with acute onset of abdominal pain and altered mental status with laboratory tests demonstrating new-onset acute liver failure. Pylephlebitis was determined to be the underlying etiology due to subsequent workup revealing polymicrobial gram-negative anaerobic bacteremia and complete thrombosis of the main and left portal veins. To our knowledge, this is the first documented case of acute liver failure as a potential life-threatening complication of pylephlebitis.
CONCLUSIONS: Our case highlights the importance of considering pylephlebitis in the broad differential for abdominal pain, especially if there are co-existing risk factors for hypercoagulability. We also demonstrate that fulminant hepatic failure in these patients can potentially be reversible with the immediate initiation of antibiotics and anticoagulation.
摘要：
背景：静脉炎是一种极其罕见的化脓性血栓性静脉炎，涉及门静脉，携带高发病率和死亡率。
方法：我们介绍一例42岁男性，无既往病史，表现为急性腹痛发作，精神状态改变，实验室检查显示新发急性肝衰竭。由于随后的检查显示多微生物革兰氏阴性厌氧性菌血症和主门静脉和左门静脉完全血栓形成，因此确定了静脉炎是潜在的病因。据我们所知,这是第一例记录的急性肝衰竭病例,它是一种潜在的危及生命的肾静脉炎并发症.
结论：我们的案例强调了在广泛鉴别腹痛中考虑静脉炎的重要性，特别是如果存在高凝状态的危险因素。我们还证明，这些患者的暴发性肝衰竭可能在立即开始使用抗生素和抗凝治疗后是可逆的。
方法：我们介绍一例42岁男性，无既往病史，表现为急性腹痛发作，精神状态改变，实验室检查显示新发急性肝衰竭。由于随后的检查显示多微生物革兰氏阴性厌氧性菌血症和主门静脉和左门静脉完全血栓形成，因此确定了静脉炎是潜在的病因。据我们所知,这是第一例记录的急性肝衰竭病例,它是一种潜在的危及生命的肾静脉炎并发症.
结论：我们的案例强调了在广泛鉴别腹痛中考虑静脉炎的重要性，特别是如果存在高凝状态的危险因素。我们还证明，这些患者的暴发性肝衰竭可能在立即开始使用抗生素和抗凝治疗后是可逆的。
