Interval laparoscopic appendectomy for appendicitis complicated by pylephlebitis.


Journal Article (Review)

BACKGROUND: Although rare, portal mesenteric venous thrombosis and pylephlebitis remain potential life-threatening sequelae of ruptured appendicitis in children. Treatment recommendations from recent reports have included urgent exploratory laparotomy with appendectomy, prolonged intravenous antibiotic therapy, and anticoagulation for up to a year. METHODS: This report describes successful management of pylephlebitis and mesenteric venous thrombosis complicating ruptured appendicitis with intravenous antibiotics and anticoagulation followed by interval laparoscopic appendectomy. RESULTS: A previously healthy 5-year-old girl was diagnosed with ruptured appendicitis complicated by pylephlebitis and mesenteric venous thrombosis at the time of presentation. She was treated with intravenous antibiotics and anticoagulated for 3 months. She subsequently underwent interval laparoscopic appendectomy. At 3-year follow-up, she is healthy without evidence of adverse sequelae. DISCUSSION: This is the first reported case of successful, minimally invasive management of ruptured appendicitis complicated by mesenteric venous thrombosis and pylephlebitis. CONCLUSION: Similar treatment of other children with this rare presentation seems reasonable.

Full Text

Duke Authors

Cited Authors

  • Stitzenberg, KB; Piehl, MD; Monahan, PE; Phillips, JD

Published Date

  • January 2006

Published In

Volume / Issue

  • 10 / 1

Start / End Page

  • 108 - 113

PubMed ID

  • 16709373

Pubmed Central ID

  • 16709373

International Standard Serial Number (ISSN)

  • 1086-8089


  • eng

Conference Location

  • United States