Hamidi K, Pauwels A, Bingen M, Simo A C, Medini A, Jarjous N, Delafolie A, Barraud D
Service d'Hépato-Gastroentérologie, Centre Hospitalier de Gonesse, Gonesse cedex, France.
Gastroenterol Clin Biol. 2008 Aug-Sep;32(8-9):734-9. doi: 10.1016/j.gcb.2008.06.002. Epub 2008 Sep 5.
Septic pylephlebitis is usually a complication of intraabdominal infection in the region drained by the portal venous system. We report two cases of portal and mesenteric venous thrombosis associated with Fusobacterium necrophorum bacteremia, which did not show any obvious intra-abdominal source of infection with noninvasive imaging procedures. In one case, early anticoagulation treatment was associated with repermeation of the portal vein and its right branch. As in Bacteroides bacteremia, portal and/or mesenteric venous thrombosis should be searched for in case of Fusobacterium bacteremia of unknown origin. Repermeation of the portal vein and relief of extrahepatic portal hypertension can be achieved in these cases with early anticoagulation.
化脓性门静脉炎通常是门静脉系统引流区域腹腔内感染的并发症。我们报告了两例与坏死梭杆菌菌血症相关的门静脉和肠系膜静脉血栓形成病例,通过非侵入性成像检查未发现任何明显的腹腔内感染源。在其中一例中,早期抗凝治疗与门静脉及其右支再通有关。与拟杆菌菌血症一样,对于不明来源的坏死梭杆菌菌血症,应检查是否存在门静脉和/或肠系膜静脉血栓形成。在这些病例中,早期抗凝可实现门静脉再通和肝外门静脉高压的缓解。