An unconventional therapeutic approach for a severe case of septic pylephlebitis involving the portal system using pharmacomechanical thrombolysis and thrombectomy

Pylephlebitis has a high risk of mortality. Even with optimal medical management, the thrombus may propagate and require intervention. We present one such case in which extension of the thrombus from the superior mesenteric vein to the intrahepatic portal veins led to a life-threatening systemic res...

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Bibliographic Details
Main Authors: Richard Ricca, MD, FACS, Rachel Grinnan, DO, Joseph Brandt, DO
Format: Article
Language:English
Published: Elsevier 2020-06-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468428720300460
Description
Summary:Pylephlebitis has a high risk of mortality. Even with optimal medical management, the thrombus may propagate and require intervention. We present one such case in which extension of the thrombus from the superior mesenteric vein to the intrahepatic portal veins led to a life-threatening systemic response. Current endovascular techniques tailored with targeted pharmacomechanical thrombolytic therapy were combined with an exploratory laparotomy for septic control and resulted in an accelerated recovery.
ISSN:2468-4287