APENDEKTOMİ SONRASI NADİR BİR KOMPLİKASYON, PORTAL VEN TROMBÜSÜ

Yıl 2023, Cilt: 4 Sayı: 2, 147 - 150, 28.07.2023

Mustafa Salış , Esra Akcan

https://doi.org/10.48176/esmj.2023.123

Öz

Portal ven trombozu, portal veni oluşturannbölümlerin trombüsle tam veya parsiyel obstrüksiyonudur. Hastalarda çoğu zaman karın ağrısı gibi non spesifik semptomlar bulunmaktadır. Bu nedenle tanı genellikle rastlantısal konur. Erken tedavi edilmez ise mortalite oranı %50’lere kadar çıkmaktadır. Bu nedenle özellikle cerrahların ve acil servis hekimlerinin aklında bulunması gereken önemli bir ayırıcı tanıdır. Bu vaka sunumumuzda; appendektomi sonrası karın ağrısı şikayeti ile acil servise başvuran ve abdominal görüntüleme yöntemlerinde portal vende trombüs saptanan 40 yaşındaki bir erkek hastayı sunmayı amaçladık.

Anahtar Kelimeler

portal trombüs, akut apandisit, piyeloflebit

A RARE COMPLICATION AFTER APPENDECTOMY, PORTAL VEIN THROMBUS

Öz

Portal vein thrombosis is the complete or partial obstruction of the parts of the portal vein by a thrombus. Patients often have non-specific symptoms such as abdominal pain. Therefore, the diagnosis is usually made incidentally. If not treated early, the mortality rate can reach up to 50%. Therefore, it is an important differential diagnosis that should be kept in mind especially by surgeons and emergency physicians. In this case presentation; We aimed to present a 40-year-old male patient who was admitted to the emergency department with the complaint of abdominal pain after appendectomy and a portal vein thrombus was detected in abdominal imaging methods.

Anahtar Kelimeler

portal thrombus, acute appendicitis, pyelophlebitis

Kaynakça

• 1. Barlas SU, Günerhan Y, Palanci Y, Işler B, Çağlayan K. Epidemiological and demographic features of appendicitis and influences of several environmental factors. Turk J Trauma Emerg Surg. 2010;16:38-42.
• 2. Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H. Portal vein thrombosis; risk factors, clinical presentation and treatment. BMC Gastroenterol. 2007;7:1-6.
• 3. Ögren M, Bergqvist D, Björck M, Acosta S, Eriksson H, Sternby NH. Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23 796 consecutive autopsies. World journal of gastroenterology: WJG. 2006;12:2115.
• 4. Chang YS, Min SY, Joo SH, Lee SH. Septic thrombophlebitis of the porto-mesenteric veins as a complication of acute appendicitis. World journal of gastroenterology: WJG. 2008;14:4580.
• 5. Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clinical Infectious Diseases. 1995;21:1114-20.
• 6. Giuliano CT, Zerykier A, Haller JO, et al. Radiological Case of the Month-Pylephlebitis Secondary to Unsuspected Appendiceal Rupture. American Journal of Diseases of Children 1989:1099-1100.
• 7. Baril N, Wren S, Radin R, Ralls P, Stain S. The role of anticoagulation in pylephlebitis. The American Journal of Surgery. 1996;172:449-53.
• 8. Tung JY, Johnson JL, Liacouras CA. Portal-mesenteric pylephlebitis with hepatic abscesses in a patient with Crohn’s disease treated successfully with anticoagulation and antibiotics. J Pediatr Gastroenterol Nutr. 1996;23:474-8.
• 9. Chang TN, Tang L, Keller K, Harrison MR, Farmer DL, Albanese CT. Pylephlebitis, portal-mesenteric thrombosis, and multiple liver abscesses owing to perforated appendicitis. J Pediatr Surg. 2001;36:19-21.
• 10. Stitzenberg KB, Piehl MD, Monahan PE, Phillips JD. Interval laparoscopic appendectomy for appendicitis complicated by pylephlebitis. JSLS. 2006;10:108.
• 11. Sogaard KK, Astrup LB, Vilstrup H, Gronbaek H. Portal vein thrombosis; risk factors, clinical presentation and treatment. BMC Gastroenterol. 2007;7:1-6.
• 12. Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr. 2000;24:755-60 13. Baril N, Wren S, Radin R, Ralls P, Stain S. The role of anticoagulation in pylephlebitis. The American journal of surgery. 1996;172:449-53.
• 14. Vanamo K, Kiekara O. Pylephlebitis after appendicitis in a child. J Pediatr Surg. 2001;36:1574-6.
• 15. Slovis TL, Haller JO, Cohen HL, Berdon WE, Watts Jr FB. Complicated appendiceal inflammatory disease in children: pylephlebitis and liver abscess. Radiology. 1989;171:823-5.
• 16. Nishimori H, Ezoe E, Ura H, et al. Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case. Surg Today. 2004;34:173-6.
• 17. Lim HE, Cheong HJ, Woo HJ, et al. Pylephlebitis associated with appendicitis. Korean J Intern Med. 1999;14:73.
• 18. Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr. 2000;24:755-60.
• 19. Vanamo K, Kiekara O. Pylephlebitis after appendicitis in a child. J Pediatr Surg. 2001;36:1574-6.
• 20. Sheen CL, Lamparelli H, Milne A, Green I, Ramage JK. Clinical features, diagnosis and outcome of acute portal vein thrombosis. Qjm. 2000;93:531-4.
• 21. Francesca RP, Maria AZ, Chiara C, et al. Portal vein thrombosis: Insight into physiopathology, diagnosis, and treatment. Wld J. Gastroenterol. 2010; 16:143-155.