Nederlands tijdschrift voor geneeskunde · 2014
[Pylephlebitis with an uncommon aetiology].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Eising Josine, Douma Matthijs R, Meijer Wim G
Аннотация
BACKGROUND: Pylephlebitis is a septic thrombophlebitis of the portal vein due to an intra-abdominal infection in the drainage area of this vein.
CASE DESCRIPTION: We describe the case of a 77-year-old woman who presented at the emergency department with fever, cold chills and a two-month history of right upper quadrant abdominal pain. She was diagnosed with pylephlebitis without a clear infection site. Treatment consisted of antibiotics and anticoagulation. Two months after discharge she was again referred to the emergency department, this time with rectal blood loss. On endoscopy a cocktail stick was seen to be stuck in a diverticulum, 14 cm from the anus. The cocktail stick was endoscopically removed. In hindsight, the cocktail stick had been visible in the proximal colon on a previous abdominal CT scan. The pylephlebitis was probably due to a covered perforation of the caecum caused by the ingested cocktail stick which had then migrated to the distal colon.
CONCLUSION: This case illustrates the importance of discovering the aetiology of pylephlebitis to avoid possible complications.
CASE DESCRIPTION: We describe the case of a 77-year-old woman who presented at the emergency department with fever, cold chills and a two-month history of right upper quadrant abdominal pain. She was diagnosed with pylephlebitis without a clear infection site. Treatment consisted of antibiotics and anticoagulation. Two months after discharge she was again referred to the emergency department, this time with rectal blood loss. On endoscopy a cocktail stick was seen to be stuck in a diverticulum, 14 cm from the anus. The cocktail stick was endoscopically removed. In hindsight, the cocktail stick had been visible in the proximal colon on a previous abdominal CT scan. The pylephlebitis was probably due to a covered perforation of the caecum caused by the ingested cocktail stick which had then migrated to the distal colon.
CONCLUSION: This case illustrates the importance of discovering the aetiology of pylephlebitis to avoid possible complications.