title: Interval laparoscopic appendectomy for appendicitis complicated by pylephlebitis.
abstract: BACKGROUND
  Although rare, portal mesenteric venous thrombosis and pylephlebitis remain potential life-threatening sequelae of ruptured appendicitis in children. Treatment recommendations from recent reports have included urgent exploratory laparotomy with appendectomy, prolonged intravenous antibiotic therapy, and anticoagulation for up to a year.
  
  
  METHODS
  This report describes successful management of pylephlebitis and mesenteric venous thrombosis complicating ruptured appendicitis with intravenous antibiotics and anticoagulation followed by interval laparoscopic appendectomy.
  
  
  RESULTS
  A previously healthy 5-year-old girl was diagnosed with ruptured appendicitis complicated by pylephlebitis and mesenteric venous thrombosis at the time of presentation. She was treated with intravenous antibiotics and anticoagulated for 3 months. She subsequently underwent interval laparoscopic appendectomy. At 3-year follow-up, she is healthy without evidence of adverse sequelae.
  
  
  CONCLUSIONS
  This is the first reported case of successful, minimally invasive management of ruptured appendicitis complicated by mesenteric venous thrombosis and pylephlebitis.
  
  
  CONCLUSIONS
  Similar treatment of other children with this rare presentation seems reasonable.
authors.affiliation: Cecil G. Sheps Center for Health Services Research and Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Karyn B
authors.initials: KB
authors.lastname: Stitzenberg
authors.forename: Mark D
authors.initials: MD
authors.lastname: Piehl
authors.forename: Paul E
authors.initials: PE
authors.lastname: Monahan
authors.forename: J Duncan
authors.initials: JD
authors.lastname: Phillips
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000188:drug therapy; D008642:Mesenteric Veins; D011169:Portal Vein; D013924:Thrombophlebitis / Q000150:complications* / Q000188:drug therapy; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants