PDF(Pubmed)
Abstract：
Pylephlebitis, which is a type of septic thrombophlebitis of the portal vein, is a rare and life-threatening complication that commonly occurs following appendicitis. However, nonspecific abdominal complaints and fever can impede the diagnosis of pylephlebitis. Timely use of appropriate antibiotics and anticoagulants is paramount for treating this condition. We present a case of pylephlebitis and septic shock caused by acute nonperforated appendicitis. A 32-year-old man presented with migratory right lower abdominal pain. Blood cultures showed the presence of Escherichia coli. Blood test results showed increased bilirubin concentrations and coagulation factor abnormalities. A computed tomographic abdominal scan showed that the portal vein had a widened intrinsic diameter. After intensive care treatment with antibiotics, antishock therapy, anticoagulants, and other supportive treatments, the infection was monitored, the abdominal pain disappeared, and the jaundice subsided. Laparoscopic appendectomy was performed. Histopathology showed acute suppurative appendicitis, and no abnormalities were observed during the follow-up period after discharge. A multidisciplinary approach is mandatory for the decision-making process in the presence of pylephlebitis caused by appendicitis to obtain a correct diagnosis and prompt treatment. Similarly, the timing of appendectomy is important for minimizing intra- and postoperative complications.
摘要：
静脉炎,这是一种感染性门静脉血栓性静脉炎，是一种罕见且危及生命的并发症，通常发生在阑尾炎后。然而,非特异性腹部不适和发热可阻碍肾静脉炎的诊断。及时使用适当的抗生素和抗凝剂对于治疗这种疾病至关重要。我们介绍了一例由急性非穿孔性阑尾炎引起的静脉炎和感染性休克。一名32岁男子表现为迁徙性右下腹疼痛。血培养物显示存在大肠杆菌。血液检测结果提示胆红素浓度升高和凝血因子异常。计算机断层扫描腹部扫描显示门静脉的固有直径变宽。经过抗生素的重症监护治疗，抗休克治疗,抗凝剂,和其他支持性治疗，对感染进行了监测，腹痛消失了,黄疸消退了.进行腹腔镜阑尾切除术。组织病理学显示急性化脓性阑尾炎，出院后随访期间未见异常。在阑尾炎引起的门静脉炎存在的情况下，多学科方法对于决策过程是强制性的，以获得正确的诊断和及时的治疗。同样，阑尾切除术的时机对于减少术中和术后并发症非常重要.
