Acute pylephlebitis following gastrointestinal infection: an unrecognized cause of septic shock.
Pylephlebitis is the septic thrombosis of the portal vein. Hypercoagulability and intra-abdominal sepsis are the main predisposing factors. A 25-year-old man presented to a primary health care center complaining of fever, epigastric pain, and jaundice. He was initially diagnosed with a gastrointestinal infection and alcoholic hepatitis and, due to his unstable clinical status, was referred to the emergency room. A diagnosis of acute pylephlebitis complicated with septic shock was made. Treatment with a wide-spectrum antibiotic and anticoagulation was initiated. Fifteen days later, recanalization of the portal vein was achieved and clinical status was improved. Pylephlebitis following gastrointestinal infection is a potential cause of septic shock.
Altamirano
José
J
Liver Unit, Institut Clinic de Malaties Digestives I Metabòliques, Hospital Clinic i Provincial, Barcelona, Spain. dr_altamirano@hotmail.com
Zapata
Laura
L
Poblano
Manuel
M
Rodríguez
Agustín
A
Camargo
Leonardo
L
Martínez
Belinda
B
Bataller
Ramón
R
D000074:Acenocoumarol / Q000627:therapeutic use; D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000188:drug therapy; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008297:Male; D010689:Phlebitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011169:Portal Vein / Q000000981:diagnostic imaging; D011859:Radiography; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D006493:Heparin; D000074:Acenocoumarol