Degano Lucas Alberto, El Kik Soraya Anis, Rizzi Ana
Hospital Prof. Dr. Juan P. Garrahan, Buenos Aires.
Arch Argent Pediatr. 2014 Aug;112(4):e163-6. doi: 10.5546/aap.2014.e163.
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.
门静脉炎被定义为门静脉或其分支的血栓性静脉炎。它是一种罕见疾病,通常与急性阑尾炎相关,且发病率和死亡率很高。多普勒超声和计算机断层扫描是确诊的首选方法。这些患者最常见的长期并发症是门静脉海绵样变性,继而出现门静脉高压。早期诊断、及时的抗生素治疗和感染清除是降低死亡率的关键治疗措施。儿童抗凝治疗的必要性仍存在争议。我们报告一例患有急腹症和脓毒症的儿童,诊断为继发于阑尾炎症的门静脉炎。该患者接受了长期抗生素治疗和皮下抗凝治疗。延期阑尾切除术取得了良好效果。