RESUMO
La pileflebitis se define como la tromboflebitis de la vena porta y/o de sus ramas. En pediatría, se presenta con mayor frecuencia asociada a un cuadro de apendicitis aguda y tiene una alta morbimortalidad. La ecografía Doppler y la tomografía computada son los estudios de elección para la confirmación del diagnóstico. La complicación a largo plazo más frecuente que pueden presentar estos niños es el cavernoma de la porta con la consiguiente hipertensión portal. El diagnóstico temprano, el tratamiento antibiótico adecuado y la remoción del foco infeccioso son las medidas terapéuticas necesarias para disminuir la mortalidad. La terapia anticoagulante es controvertida. Comunicamos el caso de un niño con abdomen agudo y sepsis, en quien se diagnosticó pileflebitis secundaria a plastrón apendicular. El paciente fue tratado con antibioticoterapia parenteral prolongada y anticoagulación subcutánea. En forma diferida, se efectuó cirugía del plastrón apendicular con adecuada recuperación posterior.
Pylephlebitis is defined as thrombophlebitis of the portal vein or its tributaries. It is a rare disease commonly associated with acute appendicitis and it has a high rate of morbidity and mortality. Doppler ultrasound and computed tomography scan are the methods of choice to confirm diagnosis. The most frequent long-term complication in these patients is portal vein cavernoma, with subsequent portal hypertension. An early diagnosis, timely antibiotic therapy and removal of infection are essential therapeutic measures to diminish mortality. The need for anticoagulation therapy in children remains controversial. We report on a child with acute abdomen and sepsis with a diagnosis of pylephlebitis secondary to appendiceal inflammation. The patient received long-term antibiotic therapy and subcutaneous anticoagulation. Deferred appendectomy was performed with favorably outcome.
Assuntos
Humanos , Masculino , Criança , Veia Porta , Tromboflebite/diagnósticoRESUMO
Pylephlebitis is defined as thrombophlebitis of the portal vein or its tributaries. It is a rare disease commonly associated with acute appendicitis and it has a high rate of morbidity and mortality. Doppler ultrasound and computed tomography scan are the methods of choice to confirm diagnosis. The most frequent long-term complication in these patients is portal vein cavernoma, with subsequent portal hypertension. An early diagnosis, timely antibiotic therapy and removal of infection are essential therapeutic measures to diminish mortality. The need for anticoagulation therapy in children remains controversial. We report on a child with acute abdomen and sepsis with a diagnosis of pylephlebitis secondary to appendiceal inflammation. The patient received long-term antibiotic therapy and subcutaneous anticoagulation. Deferred appendectomy was performed with favorably outcome.
Assuntos
Veia Porta , Tromboflebite/diagnóstico , Criança , Humanos , MasculinoRESUMO
Pylephlebitis is defined as thrombophlebitis of the portal vein or its tributaries. It is a rare disease commonly associated with acute appendicitis and it has a high rate of morbidity and mortality. Doppler ultrasound and computed tomography scan are the methods of choice to confirm diagnosis. The most frequent long-term complication in these patients is portal vein cavernoma, with subsequent portal hypertension. An early diagnosis, timely antibiotic therapy and removal of infection are essential therapeutic measures to diminish mortality. The need for anticoagulation therapy in children remains controversial. We report on a child with acute abdomen and sepsis with a diagnosis of pylephlebitis secondary to appendiceal inflammation. The patient received long-term antibiotic therapy and subcutaneous anticoagulation. Deferred appendectomy was performed with favorably outcome.
