Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Case Report

Superior Mesenteric Venous (SMV) Thrombosis Accompanied with Appendicitis in a Patient with Primary Diagnosis of Typhoid Fever

Author(s): Alireza Adibimehr, SeyedAhmad SeyedAlinaghi, Anahid Nourian, Zeinab Mehrabi and Rohollah Moslemi*

Volume 21, Issue 4, 2021

Published on: 31 July, 2020

Page: [634 - 636] Pages: 3

DOI: 10.2174/1871526520666200731180042

Price: $65

Abstract

Background: Septic thrombophlebitis of the Superior Mesenteric Venous (SMV) is rarely accompanied by appendicitis, and symptoms are atypical, so the diagnosis is commonly delayed, resulting in it is associated with high mortality.

Case Presentation: We report a case of neglected SMV septic thrombophlebitis is caused by appendicitis. The patient represented with fever, vague abdominal pain without rebound tenderness, and history of the consumption of contaminated water. Antibiotic initiated due to suspicious typhoid fever. Then typhoid fever was ruled out. Computed tomography (CT) scans revealed micro-abscess forming complicated appendicitis and the thrombus in SMV.

Discussion and Conclusion: The patient underwent a laparoscopic appendectomy, during which retrocecal gangrened perforated appendix with a 2×2 cm abscess was drained. Based on positive culture with ESBL organism meropenem was initiated. Appendectomy and treatment with broad- -spectrum antibiotics and anticoagulation led to a full recovery.

Keywords: Septic thrombophlebitis, superior mesenteric venous, appendicitis, appendectomy, retrocecal, abscess.

Graphical Abstract

[1]
Karam, M.M.; Abdalla, M.F.; Bedair, S. Isolated superior mesenteric venous thrombophlebitis with acute appendicitis. Int. J. Surg. Case Rep., 2013, 4(4), 432-434.
[http://dx.doi.org/10.1016/j.ijscr.2011.10.019] [PMID: 23500734]
[2]
Lee, K.W.; Choi, Y.I. Superior mesenteric vein thrombosis accompanied with severe appendicitis. Korean J. Hepatobiliary Pancreat. Surg., 2014, 18(3), 101-103.
[http://dx.doi.org/10.14701/kjhbps.2014.18.3.101] [PMID: 26155260]
[3]
Choudhry, A.J.; Baghdadi, Y.M.; Amr, M.A.; Alzghari, M.J.; Jenkins, D.H.; Zielinski, M.D. Pylephlebitis: a review of 95 cases. J. Gastrointest. Surg., 2016, 20(3), 656-661.
[http://dx.doi.org/10.1007/s11605-015-2875-3] [PMID: 26160320]
[4]
Chang, P.K.; Hsu, K.F.; Yu, J.C.; Chang, Y.M.; Chan, D.C.; Liao, G.S. Acute appendicitis with superior mesenteric vein septic thrombophlebitis. J. Chin. Med. Assoc., 2012, 75(4), 187-189.
[http://dx.doi.org/10.1016/j.jcma.2012.02.012] [PMID: 22541149]
[5]
Figueiras, RG; Paz, ML; González, SB; Martín, CV Pylephlebitis Radiology, 2010, 225(3)
[6]
Castro, R; Fernandes, T; Oliveira, MI Castro M. Acute appendicitis complicated by pylephlebitis: a case report. Case Rep. Radiol, 2013.
[http://dx.doi.org/10.1155/2013/627521]
[7]
Eduardo, L.; David, H.Z.; Margarita Felipe, R.C.; Medellín Anwar, M. Pylephlebitis both a surgical and non-surgical pathology: A 2-case report and literature review. J Liver Res Disord Ther., 2018, 4(2), 77-80.
[http://dx.doi.org/10.15406/jlrdt.2018.04.00104]
[8]
García Figueiras, R.; Liñares Paz, M.; Baleato González, S.; Villalba Martín, C. Case 158: Pylephlebitis. Radiology, 2010, 255(3), 1003-1007.
[http://dx.doi.org/10.1148/radiol.10081543] [PMID: 20501737]
[9]
Ufuk, F.; Herek, D.; Karabulut, N. Pylephlebitis complicating acute appendicitis: prompt diagnosis with contrast-enhanced computed tomography. J. Emerg. Med., 2016, 50(3), e147-e149.
[http://dx.doi.org/10.1016/j.jemermed.2015.06.083] [PMID: 26810023]
[10]
Chirinos, J.A.; Garcia, J.; Alcaide, M.L.; Toledo, G.; Baracco, G.J.; Lichtstein, D.M. Septic thrombophlebitis: diagnosis and management. Am. J. Cardiovasc. Drugs, 2006, 6(1), 9-14.
[http://dx.doi.org/10.2165/00129784-200606010-00002] [PMID: 16489845]
[11]
Nishimori, H.; Ezoe, E.; Ura, H.; Imaizumi, H.; Meguro, M.; Furuhata, T.; Katsuramaki, T.; Hata, F.; Yasoshima, T.; Hirata, K.; Asai, Y. Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case. Surg. Today, 2004, 34(2), 173-176.
[http://dx.doi.org/10.1007/s00595-003-2654-8] [PMID: 14745623]
[12]
Kanellopoulou, T.; Alexopoulou, A.; Theodossiades, G.; Koskinas, J.; Archimandritis, A.J. Pylephlebitis: an overview of non-cirrhotic cases and factors related to outcome. Scand. J. Infect. Dis., 2010, 42(11-12), 804-811.
[http://dx.doi.org/10.3109/00365548.2010.508464] [PMID: 20735334]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy