Pylephlebitis as a Complication of Acute Appendicitis in a Pregnant Patient

Abstract

Introduction: Pylephlebitis, septic thrombosis of the portal system due to acute abdominal inflammatory conditions, it presents with variable clinical signs depending on the cause of origin and the affected portal branch. Diagnosis includes normal or mildly impaired liver function with leukocytosis, positive blood cultures, Doppler echocardiography, or computed tomography confirming the disease.

Objective: To describe pylephlebitis as an unusual complication in a pregnant patient with acute appendicitis, referring to its concept, pathophysiology, clinical presentation, diagnosis and therapeutic measures.

Clinical case report: This is the case of an 18-year-old female pregnant patient, who had severe abdominal pain, accompanied by vomiting, diarrhea and jaundiced stools. For such reasons, she was transferred to the Ambato General Teaching Hospital. Sepsis of abdominal origin was diagnosed due to acute perforated appendicitis, generalized peritonitis complicated with pylephlebitis. Surgical intervention was performed and the clinical condition was solved.

Conclusions: Pylephlebitis represents a great diagnostic difficulty, hence tools such as Doppler ultrasound and computed tomography are helpful in these cases. The mainstays of treatment include control of the abdominal septic focus and treating pylephlebitis.

Keywords: appendicitis; pregnancy; pylephlebitis; tomography.