Background: Pylephlebitis is a septic thrombophlebitis of the porto-mesenteric veins, an extremely rare complication of intraabdominal infections especially in the region drained by the portal systems or in the structure contiguous to the portal vein, It is associated with a high mortality even early dignosis and appropriate treatment.

Aims: Here, we report a case of septic thrombophlebitis of the portal and superior mesenteric veins with multiple liver abscesses caused by ruptured appendicitis.

Methods: A case is presented.

Results: A 17 years old girl was referred to our hospital with an initial diagnosis of acute hepatitis because of prolonged fever, abdominal pain, hyperbiluribinemia and elevated liver enzymes. However virali nfections which can cause hepatitis was found to be negative. Complete blood count showed leukocytosis (WBC:18900/mm3 )with increased number of immature leukocytes. Abdominal CT showed portal and superior mezentheric vein thrombosis with multiple liver abscess. Moreover, there was an irregularity of the cecum wall and appendix which was compatible with a ruptured appendicitis . She was treated with long-term antibiotics and anticoagulation.

Conclusions: This rare complication is reported to be associated with up to a 50% mortality rate.Early diagnosis with abdominal CT is the key point of the treatment. Moreover, this complicatıon may also result in a portal hypertension and chronic liver disease even treated with an appropriate approach.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/a-rare-case-of-phlephlebitis-an-unusual-underlying-reason-for-portal-venous-thrombosis/