Pileflebitis, complicación extraña de apendicitis aguda en paciente gestante, reporte de un caso

Abstract

Objective: To characterize a pregnant patient who presents with pileflebitis as a strange complication of acute appendicitis. Discussion: A case of a pregnant 18-year-old female patient is reported, who reports diffuse abdominal pain of moderate to great intensity, accompanied by vomiting and diarrheal stools, as well as jaundice in the chest and legs. Hepatitis was diagnosed clinically without specifying the results of examinations and treatment that was not referred started, as she did not show improvement, she was transferred to the Ambato General Teaching Hospital. The previous clinical picture is ruled out with an in-depth physical examination and complementary examinations, confirming the presence of sepsis of abdominal origin due to acute perforated appendicitis, generalized peritonitis complicated by pilephlebitis; surgical intervention and resolution of the clinical picture is performed. Materials and methods: A retrospective descriptive study based on clinical case analysis is carried out. Conclusions: After reviewing the clinical case and the bibliography, it is concluded that pilephlebitis is septic thrombosis of the portal system due to acute abdominal inflammatory conditions; It presents with variable clinical manifestations depending on the cause of origin and by affected portal branch. The diagnosis includes normal or slightly altered liver function with leukocytosis, positive blood cultures, Doppler ultrasound or computed tomography corroborating the pathology. For therapeutic measures, control of the septic focus, liver abscesses and pylephlebitis is considered.