title: [Pylephlebitis: a rare but possible complication of intra-abdominal infections].
abstract: BACKGROUND
  Pylephlebitis or septic thrombophlebitis of the portal venous system is a rare but serious complication of intra-abdominal infections which drain into the portal venous system. Its diagnosis is based on clinical suspicion and imaging tests, mainly a computed tomography scan, given the lack of specificity of the signs and symptoms. Spread of septic emboli is the major cause of morbidity and mortality. The aim of the study was to analyse patients diagnosed in our hospital.
  
  
  METHODS
  Retrospective descriptive study of patients diagnosed with pylephlebitis in our hospital.
  
  
  METHODS
  Four patients were included, 3 men and one woman. In 3 cases it was acute cholecystitis that led to the diagnosis of pylephlebitis at the same time as the intra-abdominal infection. Emergency surgery was performed in one case, whilst the other 2 were treated conservatively. Blood cultures were performed in all cases, and empirical antibiotic treatment was used. In the only case of acute appendicitis, diagnosis of pylephlebitis was achieved during the study of postoperative fever, with empirical antibiotic treatment also being started. The haematologist was requested to start the required anticoagulation therapy in all cases.
  
  
  CONCLUSIONS
  Pylephlebitis is a rare complication of intra-abdominal infections that may make lead to a worse outcome. A high level of suspicion is required as well as imaging tests to make an early diagnosis and appropriate treatment.
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España. Electronic address: susanaperezbru@gmail.com.
authors.forename: Susana
authors.initials: S
authors.lastname: Pérez-Bru
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Nofuentes-Riera
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: García-Marín
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Paloma
authors.initials: P
authors.lastname: Luri-Prieto
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Morales-Calderón
authors.affiliation: Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España.
authors.forename: Salvador
authors.initials: S
authors.lastname: García-García
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications*; D016470:Bacteremia / Q000209:etiology; D001442:Bacteroides Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D002763:Cholecystectomy; D002764:Cholecystitis / Q000150:complications* / Q000601:surgery; D060085:Coinfection; D003131:Combined Modality Therapy; D004617:Embolism / Q000209:etiology*; D004630:Emergencies; D016984:Enterococcus faecium / Q000302:isolation & purification; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D041121:Klebsiella oxytoca / Q000302:isolation & purification; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000382:microbiology; D012189:Retrospective Studies; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants
keywords: Acute cholecystitis; Colecistitis aguda; Pileflebitis; Portal vein thrombosis; Pylephlebitis; Trombosis venosa portal