| Clinical characteristics and radiologic findings of pylephlebitis |
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Tae Dong Kim, Tae Nyeun Kim, Hee Ju Oh, Jun Hwan Kim, Hun Ju Lee, Won Kyu Park, Jae Chun Jang |
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Department of Medicine, Sungkyunkwan University School of Medicine |
| 증례 : 문맥염 6예의 임상 양상 및 방사선학적 소견 |
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김태동&#;김태년&#;오희주&#;김준환&#;이헌주&#;박원규&#;장재천, Tae Nyeun Kim, Hee Ju Oh, Jun Hwan Kim, Hun Ju Lee, Won Kyu Park, Jae Chun Jang |
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| Abstract |
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Pylephlebitis, a suppurative thrombophlebitis of the portal venous system, is a rare complication of intra-abdominal sepsis usually followed by infection either in the region draining the portal system or in the structure contiguous to the portal vein. Early diagnosis and initiation of adequate antibiotic therapy is important for improving the long-term prognosis of patients suffering from this rare disease, so we retrospectively reviewed 6 cases of pylephlebitis.
All patients were males with a mean follow-up of 11 months (range 5～24 months). Clinical symptoms consisted of fever (100%), right upper abdominal pain (100%), jaundice (33.3%), and diarrhea (16.6%). Anemia and leukocytosis were found in 6 patients. Suspected etiology was acute cholangitis in 2 patients, acute appendicitis in 1 patient and idiopathic in 3 patients. All patients were successfully diagnosed with dynamic CT scan which showed the presence of portal vein thrombosis (100%), superior mesenteric vein thrombosis (66.6%), liver abscess (33.3%), and biloma (16.6%).
Patients were treated with the systemic administration of a broad spectrum antibiotics and 1 patient was given anticoagulant. Initial symptoms were improved in all patients and some beneficial effects of anticoagulation are expected to achieve the recanalization of thrombosis and prevent atrophic changes in the liver, but further studies on the kind of therapy are needed.(Korean J Med 69:S798-S806, 2005)
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| Key Words:
Pylephlebitis, Portal vein thrombosis |
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