Pylephlebitis is a septic inflammation and thrombosis of the portal vein of the liver. This disease is a rare complication that occurs as a result of the spread of infection in the abdominal cavity (for example, with appendicitis).
As mentioned above, pylephlebitis often occurs with acute appendicitis. In addition, pylephlebitis can occur with pancreatitis, cholecystitis, and in the postpartum period in women.
The source of pylephlebitis is thrombosed mesenteric veins of the appendix. As a result, the process spreads to the portal vein and its branches. When the intrahepatic branches of the portal vein are affected in the process, multiple abscesses can form in the liver.
Clinically, pylephlebitis is manifested primarily by an increase in temperature to 39-40 degrees. In addition, the patient will be disturbed by intense pain in the right hypochondrium, weakness, high sweating. The skin becomes icteric.
On examination, the abdomen is soft, moderately painful in the navel and right hypochondrium. No pathology was found on rectal or vaginal examination. In the blood test – high leukocytosis with a shift of the formula to the left.
Treatment of pylephlebitis is most often carried out conservatively. It is necessary to prescribe broad-spectrum antibiotics (ceftriaxone, ceftazidime), abundant detoxification therapy. Anticoagulants are also prescribed.
With a diagnosed abscess or multiple abscesses of the liver, it is necessary to carry out surgical treatment to open and drain the abscess.