Pylephlebitis and acute mesenteric ischemia in a young man with inherited thrombophilia and suspected foodborne illness.
Pylephlebitis and acute mesenteric ischemia in a young man with inherited thrombophilia and suspected foodborne illness.
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
We report on a young man who developed complicated pylephlebitis after foodborne illness. Despite antibiotics and resection of the focus of infectious colitis, he developed extensive small bowel infarction. He was treated with anticoagulation, local thrombolytic infusion, and resection of irreversibly ischemic small bowel. Thrombophilia workup demonstrated heterozygosity for factor V Leiden and the prothrombin G20210A mutation. The complications of pylephlebitis can be minimized by using systemic anticoagulation, thrombectomy, and/or local thrombolytic infusion along with antibiotics and surgical management of the infection. Evaluation for thrombophilic states should be considered, particularly if a patient does not respond to initial therapy. Copyright 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
English
0741-5214
*Colitis/et [Etiology]
*Foodborne Diseases/co [Complications]
*Ischemia/et [Etiology]
*Portal Vein
*Thrombophilia/co [Complications]
*Thrombophlebitis/et [Etiology]
*Vascular Diseases/et [Etiology]
Adult
Anti-Bacterial Agents/tu [Therapeutic Use]
Anticoagulants/tu [Therapeutic Use]
Colectomy
Colitis/di [Diagnosis]
Colitis/th [Therapy]
Colonoscopy
DNA Mutational Analysis
Factor V/ge [Genetics]
Foodborne Diseases/di [Diagnosis]
Foodborne Diseases/th [Therapy]
Heterozygote
Humans
Ischemia/di [Diagnosis]
Ischemia/th [Therapy]
Male
Mutation
Prothrombin/ge [Genetics]
Thrombolytic Therapy
Thrombophilia/di [Diagnosis]
Thrombophilia/ge [Genetics]
Thrombophilia/th [Therapy]
Thrombophlebitis/di [Diagnosis]
Thrombophlebitis/th [Therapy]
Tomography, X-Ray Computed
Treatment Outcome
Vascular Diseases/di [Diagnosis]
Vascular Diseases/th [Therapy]
MedStar Washington Hospital Center
Surgery/Trauma Surgery
Surgery/Vascular Surgery
Case Reports
Journal Article
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
We report on a young man who developed complicated pylephlebitis after foodborne illness. Despite antibiotics and resection of the focus of infectious colitis, he developed extensive small bowel infarction. He was treated with anticoagulation, local thrombolytic infusion, and resection of irreversibly ischemic small bowel. Thrombophilia workup demonstrated heterozygosity for factor V Leiden and the prothrombin G20210A mutation. The complications of pylephlebitis can be minimized by using systemic anticoagulation, thrombectomy, and/or local thrombolytic infusion along with antibiotics and surgical management of the infection. Evaluation for thrombophilic states should be considered, particularly if a patient does not respond to initial therapy. Copyright 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
English
0741-5214
*Colitis/et [Etiology]
*Foodborne Diseases/co [Complications]
*Ischemia/et [Etiology]
*Portal Vein
*Thrombophilia/co [Complications]
*Thrombophlebitis/et [Etiology]
*Vascular Diseases/et [Etiology]
Adult
Anti-Bacterial Agents/tu [Therapeutic Use]
Anticoagulants/tu [Therapeutic Use]
Colectomy
Colitis/di [Diagnosis]
Colitis/th [Therapy]
Colonoscopy
DNA Mutational Analysis
Factor V/ge [Genetics]
Foodborne Diseases/di [Diagnosis]
Foodborne Diseases/th [Therapy]
Heterozygote
Humans
Ischemia/di [Diagnosis]
Ischemia/th [Therapy]
Male
Mutation
Prothrombin/ge [Genetics]
Thrombolytic Therapy
Thrombophilia/di [Diagnosis]
Thrombophilia/ge [Genetics]
Thrombophilia/th [Therapy]
Thrombophlebitis/di [Diagnosis]
Thrombophlebitis/th [Therapy]
Tomography, X-Ray Computed
Treatment Outcome
Vascular Diseases/di [Diagnosis]
Vascular Diseases/th [Therapy]
MedStar Washington Hospital Center
Surgery/Trauma Surgery
Surgery/Vascular Surgery
Case Reports
Journal Article