Pylephlebitis and acute mesenteric ischemia in a young man with inherited thrombophilia and suspected foodborne illness.
Citation: Journal of Vascular Surgery. 55(6):1769-72, 2012 Jun.PMID: 22520365Institution: MedStar Washington Hospital CenterDepartment: Surgery/Trauma Surgery | Surgery/Vascular SurgeryForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *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]Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:- 0741-5214
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | Available | 22520365 |
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.
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