Pylephlebitis ist Thrombophlebitis

Pylephlebitis ist Thrombophlebitis Pylephlebitis ist Thrombophlebitis

- Какие-то проблемы? - спросил лейтенант. -- Ведь было же, наверное, когда-то время. Эти Pylephlebitis ist Thrombophlebitis были встречены полным молчанием.

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Authors stated no financial relationship to disclose. A year-old man presented with abdominal pain, fever, and diarrhea. He was suspected of having enteric infection, and he received oral antibiotics and rehydration therapy. Despite these regular measures, his clinical status did not improve. Fifteen days later, the patient was admitted because of persistent fever At physical examination, his abdomen was soft and tender.

Laboratory studies revealed mild anemia, with a hemoglobin level of Bilirubin level was normal. Coagulation test results were normal. Abdominal and pelvic computed tomographic CT scanning was performed. Contrast material—enhanced CT mL of iopromide, Ultravist ; Schering, Berlin, Germany revealed a nonocclusive intrahepatic thrombus in the portal branch of the right anterior liver segment that was causing nonhomogeneous enhancement of the hepatic parenchyma Fig 1. Pylephlebitis ist Thrombophlebitis was also a Pylephlebitis ist Thrombophlebitis low-attenuation thrombus within the lumen of the superior mesenteric vein Fig 2.

Finally, CT images acquired at the level of the cecum Fig 3 showed evidence of fat stranding in the retrocecal area, a wall-thickened and contrast-enhanced appendix emerging Pylephlebitis ist Thrombophlebitis the cecum, and extraluminal gas that was indicative of perforated appendicitis. Figure 1: Transverse contrast-enhanced CT image obtained through the midportion of the liver shows a nonoclusive intrahepatic thrombus arrows in the portal branch of the right anterior liver segment, Pylephlebitis ist Thrombophlebitis nonhomogeneus enhancement of the hepatic parenchyma.

Figure 2: Transverse contrast-enhanced CT image acquired at the level of the small-bowel mesentery root shows a nonenhancing low-attenuation thrombus arrow within the lumen of the superior mesenteric vein.

Figure 3a: a, b Transverse contrast-enhanced CT images obtained at the level of the lower abdomen show evidence of fat stranding in the retrocecal area and a thick-walled and contrast-enhanced appendix arrows.

Figure 3b: a, b Transverse contrast-enhanced CT images obtained at the level of the lower abdomen show evidence of fat stranding in the retrocecal area and a thick-walled and contrast-enhanced appendix Pylephlebitis ist Thrombophlebitis. This patient Krampfadern Allgemeinanästhesie und a clinical course of prolonged fever and abdominal pain, altered liver function test results, and leukocytosis.

CT findings included portal and superior mesenteric vein thrombosis, as well as findings that were Pylephlebitis ist Thrombophlebitis with a perforated appendicitis. Portal and mesenteric http://newohioreview.com/blog/krampfadern-socken-aus-stufe-2.php thrombosis develops in patients http://newohioreview.com/blog/wunden-an-den-beinen-behandlungsanlagen.php various conditions, Pylephlebitis ist Thrombophlebitis as hypercoagulable states coagulopathies, neoplasms, pregnancy, and oral contraceptive usehematologic disorders polycythemia vera, essential thrombocythemia, and paroxysmal nocturnal hemoglobinuriaabdominal trauma, cirrhosis and portal hypertension, neoplasms, Pylephlebitis ist Thrombophlebitis, postoperative Pylephlebitis ist Thrombophlebitis, and intraperitoneal inflammatory diseases 12.

In this patient, neither imaging results nor clinical findings indicated chronic liver disease, portal hypertension, pancreatic disease, or neoplasms.

There was no history of hematologic, inherited, or acquired thrombotic disorders; abdominal trauma; or surgery. Thus, the first consideration was thrombosis secondary to an abdominal infectious process. Pylephlebitis is a septic thrombophlebitis of the portal venous system. It is usually secondary to an infection in the region drained by the portal system or in the structures contiguous to the portal vein. Pylephlebitis begins with thrombophlebitis Pylephlebitis ist Thrombophlebitis the small veins that drain the infected area 3.

Extension of Pylephlebitis ist Thrombophlebitis thrombophlebitis into larger veins leads to septic thrombophlebitis of the mesenteric vein, which can extend further to Pylephlebitis ist Thrombophlebitis the portal vein. There are a few articles in the imaging literature that describe this entity 4 — Most cases are clearly related to a different focus of intraabdominal infection.

Diverticulitis is the most common cause, but there are many others, including appendicitis, Pylephlebitis ist Thrombophlebitis infections, pelvic infections, biliary diseases, inflammatory bowel disease, and necrotizing pancreatitis 4.

In some patients, the source of infection cannot be identified. The clinical manifestation is usually confusing. The patient may be asymptomatic, exhibit minimal symptoms related to the primary infection site, or have an acute abdomen. Signs and symptoms depend on the location and extent of the thrombus and underlying disease. In the subacute form of venous mesenteric thrombosis, patients may have abdominal pain for days or weeks, without bowel infarction 2.

Liver involvement can cause hepatomegaly, elevation of liver enzyme levels, abscesses, and jaundice 7.

The organisms that are most often cultured Pylephlebitis ist Thrombophlebitis Escherichia coli and Bacteroides fragilis Imaging findings are related to venous involvement, the primary source of infection, and intrahepatic anomalies. Vascular involvement is indicated by the presence of intravascular thrombi or air 4. CT reveals venous thrombosis in a high percentage of patients, but it is less accurate in those with thrombosis of small vessels 2.

Liver imaging findings include unopacified branches of the portal vein, transient parenchymal attenuation differences, and intrahepatic abscesses 4 Patients who had thrombosis secondary to abdominal sepsis may completely recover, with recanalization of the vessel after successful treatment of the underlying sepsis, or Pylephlebitis ist Thrombophlebitis may develop multiple small collateral channels cavernous transformation or portal hypertension.

Classic symptoms and diagnostic imaging findings of appendicitis have been described 15 However, up to one-third of patients with acute appendicitis have an atypical presentation. Unusual presentations most likely occur when the appendix is in an atypical location or in older patients in whom appendicitis may go unrecognized. In patients with appendicitis, local inflammation may progress to perforation.

Perforated appendix may be contained by a local phlegmon or abscess subacute appendicitis. Specific CT criteria for perforated appendicitis include extraluminal gas, abscess, small-bowel ileus, and focal wall enhancement defect 16 — Pylephlebitis is an infrequent but known complication of appendicitis 3 — 59. The incidence of portal thrombophlebitis is 0. In summary, the combination of radiologic findings of appendicitis and multiple venous thromboses in the region drained by the portal system is highly suggestive of pylephlebitis secondary to acute appendicitis.

An early recognition of this entity may improve the course of the disease. Congratulations to the individuals and five resident groups that submitted the most likely diagnosis pylephlebitis secondary to acute appendicitis for Diagnosis Please, Case The names and locations of the individuals and resident groups, as submitted, are as follows: Hisashi Abe, MD, Suita, Osaka, Japan Gholamali Afshang, MD, Tinley Park, Ill Anjali Agrawal, MBBS, Delhi, India Elisa Aguirre Pascual, Madrid, Spain Harry A.

Allen, III, MD, Virginia Beach, Va Albert J. Alter, MD, PhD, Pylephlebitis ist Thrombophlebitis, Wis Ersan Altun, MD, Istanbul, Turkey Rodrigo Andreiuolo, Rio de Janeiro, Brazil Roger Pylephlebitis ist Thrombophlebitis. Antonelli, MD, Dayton, Ohio Guis S.

Astacio, MD, Rio de Janeiro, Brazil Asim K. Bag, MD, Birmingham, Ala Yvonne Pylephlebitis ist Thrombophlebitis, Kiel, Schleswig Holstein, Germany Alex Bedim, Muriae, Brazil Wilfried Berning, MD, Muenster, Germany Aditya Bharatha, MD, Toronto, Ontario, Canada Gustav A. Blomquist, MD, Goodlettsville, Tenn Ronald N. Boyle, MD, La Plata, Md Eric L. Bressler, MD, Minnetonka, Minn Douglas C. Brown, MD, Virginia Beach, Va Andrea Bruscagnin, MD, Venezia, Italy Michael P.

Buetow, MD, Okemos, Mich Ian A. Burgess, MD, North Sydney, Australia Rogerio Caldana, MD, Sao Paulo, Brazil Justin Campbell, MD, Brookline, Mass Antonio A. Cavalcanti, MD, Sao Paulo, Brazil Allen T. Chen, MD, Seattle, Wash Michael H. Childress, MD, Silver Spring, Md Silvia Cisneros Carpio, MD, Durango, Vizcaya, Spain Christopher J. Conners, MD, MPH, Zurich, Switzerland Yves-Sebastien Cordoliani, MD, Le Chesnay, France Sergio A.

Criales Vera, MD, Mexico John S. Cunat, MD, Lutherville, Md Marco A. Dalakidis, MD, Voula, Greece Rafael Darahem, MD, Pylephlebitis ist Thrombophlebitis, Brazil Marc G. Pylephlebitis ist Thrombophlebitis, MD, Istanbul, Turkey Thaworn Dendumrongsup, MD, Songkhla, Thailand Ronald J. Dolin, MD, Middleton, Wis Sandeep Dua, MBBS, MD, New Delhi, India Morgan G. Dunne, San Antonio, Tex Seyed A. Emamian, MD, PhD, Rockville, Md Susan M. Fanapour, DO, Lombard, Ill Zareen Fatima, MBBS, Chuo City, Japan Melvyn A.

Feliciano, Anfangs Manifestationen von, San Francisco, Calif Brett D.

Ferdinand, MD, Livingston, NJ James B. Fitzgerald, MD, Orchard Park, NY Manuela Pylephlebitis ist Thrombophlebitis, MD, Maia, Portugal Akira Fujikawa, MD, Setagaya, Tokyo, Japan Ann S. Fulcher, MD, Midlothian, Va Roel Pylephlebitis ist Thrombophlebitis. Galope, DO, Lodi, NJ Gabriela Gayer, MD, Ramat-Gan, Israel Gilles Genin, Annecy, France Bradley S.

Gluck, MD, Southampton, NY Mark G. Goldshein, MD, Andover, Mass Raquel P. Gonzalez, MD, Vigo, Pontevedra, Spain Matthew J. Grant, MD, Birmingham, Ala Kiran H. Hilal, IV, BBS, MBBS, Karachi, Sindh, Pakistan Ferris M. Hall, MD, Brookline, Mass Clint D. Hamilton, MD, Dallas, Tex David C. Harrison, MD, Salem, Ore Nobushige Hayashi, MD, PhD, Fukui-shi, Fukui, Japan Helen T. Kompressionsstrümpfe für, MD, Chicago, Ill Alvaro Huete Garin, MD, Santiago, Chile Alberto C.

Iaia, MD, Wilmington, Del Noriatsu Ichiba, MD, Otsu, Shiga, Japan Stephen F. Janas, Http://newohioreview.com/blog/der-schmerz-von-venoeser-ulcera-der-unteren-extremitaeten.php, Lake Forest, Ill Sharada Jayagopal, MD, East Williston, NY Andrew J.

Kapustin, MD, Charlotte, NC Takuji Kiryu, MD, PhD, Gifu, Japan Steven A. Klein, MD, Shrewsbury, Mass Oliver P. Krief, MD, Cote Saint Luc, Quebec, Canada Varanasi Krishna, MD, Manama, Bahrain Pat Continue reading. Kwankaew, MD, Muang, Kanchanaburi, Thailand Alexis Lacout, MD, Aurillac, France Anthony G.

Laglia, MD, Piedmont, Cali Mario A. Laguna, MD, Pylephlebitis ist Thrombophlebitis, Wis Mark S. Landis, MD, MS, London, Ontario, Canada Laurent Letourneau-Guillon, MD, Montreal, Quebec, Canada David A. Lisle, MBBS, Brisbane, Queensland, Australia Heng-Hsiao Liu, MD, Houston, Tex Jaume Llauger, MD, Barcelona, Spain Thomas H.

Louis, MD, Arlington, Tex Patricia A. Lowry, MD, Chattanooga, Tenn Edward Lubat, MD, Englewood, NJ Alex Luttich, Pylephlebitis ist Thrombophlebitis del Valles, Barcelona, Spain Oleg Lysyy, MD, Rishon Lezion, Israel Bart Maes, Visit web page, Tongeren, Limburg, Belgium Yoji Maetani, MD, Kyoto, Japan Stephen V.

Manghisi, MD, Closter, NJ Satoshi Matsushima, MD, Tokyo, Japan Waldir H. Maymone, MD, Rio de Janeiro, Brazil Ana L. Mendizabal, MD, Mexico City, Mexico Reto A.

Meuli, MD, Lausanne, Switzerland Pylephlebitis ist Thrombophlebitis J. Michel, MD, Bend, Ore Juan A.

Millan, MD, Seattle, Wash Steven F. Millward, MBChB, Peterborough, Pylephlebitis ist Thrombophlebitis, Canada Manabu Minami, MD, PhD, Yokohama, Japan Masayuki Miyajima, Fukushima, Japan Jose Mondello, MD, Buenos Aires, Argentina Hiroyuki Morisaka, Kofu, Yamanashi, Japan Toshio Moritani, MD, PhD, Iowa City, Iowa Aldo Morra, Sr, MD, PHD, Albignasego, Padova, Italy Thomas Moser, MD, Montreal, Quebec, Canada Juan Jose G. Muga, MD, Bilbao, Read article, Spain Seyed Ali Nabavizadeh, MD, Shiraz, Iran Tammam N.

Nehme, MD, East Wenatchee, Wash Soheil Niku, MD, San Diego, Calif Mizuki Nishino, MD, Boston, Mass Hiroshi Nobusawa, MD, PhD, Ota, Tokyo, Japan Laura Oleaga, Barcelona, Spain Michael D.

Orsi, MD, Baltimore, Md Klaus Orth, Aachen, Germany Carlos A. Oulton, MD, PhD, Cordoba, Argentina Vishal Panchal, San Diego, Calif Pylephlebitis ist Thrombophlebitis M. Panicek, MD, New York, NY Narendrakumar P. Patel, MD, Newburgh, NY Prakash N. Patel, MD, New City, NY Suresh K. Patel, MD, Chicago, Ill Aruna R. Patil, MBBS, New Delhi, India Avanee S. Peel, MD, La Jolla, Calif Carlo L. Petralli, MD, Basel, Switzerland Diogo L. Pinheiro, MD, Curitiba, Brazil Mimi H. Pinto, DO, Ambler, Pa John M.

Plotke, MD, Naperville, Ill David P. Poage, MD, Omaha, Neb Rubem Pochaczevsky, MD, Bronx, NY Albert V. Porambo, MD, Rockville, Md Kalyan C. Poruri, MD, South Elgin, Ill Ilias Primetis, MD, Athens, Greece Paloma Pylephlebitis ist Thrombophlebitis, MD, Barcelona, Spain Merja K. Raade, MD, Helsinki, Finland David R. Radin, MD, Studio City, Calif Michael Rado, MD, Bergheim, Germany Keshav P. Raichurkar, MD, Mysore, India Claudio P.

Ramos, MD, Juiz Pylephlebitis ist Thrombophlebitis Fora, Brazil Daniel C. Pylephlebitis ist Thrombophlebitis, MD, Toronto, Ontario, Canada Carla F. Ribeiro, MD, Viseu, Portugal Shuchi K. Rodgers, MD, Philadelphia, Pa Clifford E. Roemer, MD, Charlotte, NC Joel A. Rubenstein, MD, Portland, Ore Tsutomu Sakamoto, MD, Tokyo, Japan Pylephlebitis ist Thrombophlebitis Sakata, MD, Kurashiki, Okayama, Japan Farhad W.

Sani, MD, Oakland, Calif Pylephlebitis ist Thrombophlebitis A. Santiago, MD, Aveiro, Portugal Roberto Q. Santos, MD, Pylephlebitis ist Thrombophlebitis de Janeiro, Brazil Yildiray Savas, MD, Istanbul, Marmara, Turkey Steven Schepers, Hasselt, Limburg, Belgium Robert M. Schick, MD, Walnut Creek, Calif Felix Schmidt, MD, St Gallen, Pylephlebitis ist Thrombophlebitis Steven M.

Schultz, MD, Fort Worth, Tex Joel M. Schwartz, MD, Elmsford, NY Matthew P. Shapiro, MD, Charlottesville, Va Hideki Shima, MD, Tokyo, Japan Taro Shimono, MD, Osaka, Japan Gary Sidhu, MD, Surrey, Pylephlebitis ist Thrombophlebitis Columbia, Canada William L.

Simpson, MD, New York, NY Luis A. Sosa, Jr, Pylephlebitis ist Thrombophlebitis, Milwaukee, Wis James D. Sprinkle, Jr, MD, Spotsylvania, Va Scott Stickles, DO, New York, NY Kouichi Sugiyama, Numazu, Japan Susan L. Summerton, MD, Mullica Hill, NJ Hongliang Sun, MD, Beijing, China Suradech Suthiphosuwan, MD, Был Varizen von schwangeren Frauen, was zu tun думаю, Chiang Mai, Thailand Brooks W.

Taber, MD, Durham, NC Norio Takahashi, MD, Fukui, Japan Yukihisa Takayama, MD, Fukuoka, Japan Yumiko Oishi Tanaka, MD, Tsukuba, Ibaraki, Japan Benjamin Taragin, MD, Teaneck, NJ Neslihan Tasdelen, Istanbul, Turkey Douglas L.

Teich, MD, Brookline, Mass Ross L. Titton, MD, Voorhees, NJ Eugene Tong, MD, Austin, Tex Meric Tuzun, Ankara, Turkey Unni K. Udayasankar, MD, FRCR, Atlanta, Ga Jan E. Vandevenne, MD, Genk, Limburg, Belgium Turid Vetrhus, MD, Oslo, Norway Publio C.

Viana, MD, Sao Paulo, Brazil Christopher P. Vittore, MD, Belvidere, Ill Pylephlebitis ist Thrombophlebitis A.

Vollmer, MD, Cipolletti, Rio Negro, Argentina Nicolaus A. Wagner-Bartak, MD, Boston, Mass Nisar A. Wani, MBBS, MD, Srinagar, India Robert C. Weissmann, III, MD, Birmingham, Ala Jeffrey H. West, MD, Jacksonville, Fla Benjamin M. Whitis, MD, Eau Claire, Wis David I. Winger, MD, Lenox, Mass Bernard Wirth, MD, Lons, France Toshihide Yamaoka, MD, Kyoto, Japan Michio Yamasaki, MD, Ritto, Shiga, Japan Koji Yamashita, MD, Fukuoka, Japan Fernando I. Yamauchi, MD, Sao Paulo, Brazil Hajime Yokota, MD, Numazu, Shizuoka, Japan Kaneko You, Gifu, Japan Pylephlebitis ist Thrombophlebitis A.

Zaheer, MD, Canton, Ill Jeffrey H. Zapolsky, MD, Oshkosh, Wis Ahmed Zidan, MD, Barcelona, Spain The Hospital Povista Radiology Residents, Vigo, Spain Hospital Universitario Evangelico de Curitiba Radiology Residents, Curitiba, Brazil Naval Medical Center Residents, San Diego, Calif Prince of Songkla University Radiology Residents, Songkla, Thailand University of Pennsylvania Radiology Residents, Philadelphia, Pa Received August 28, ; revision requested September 26; revision received October 15; final version accepted December Part one of this case appeared 4 months previously and may contain larger images.

Applications Evidence-based Practice Gastrointestinal Imaging Genitourinary Imaging Health. Policy and Practice Musculoskeletal Imaging Technical. Archive of All Issues. Head and Neck Imaging. Health Policy and Practice. I Do It videos. SA-CME Objectives and Disclosures. Address correspondence to R. Show Conflicts of Interest and Funding Hide Conflicts of Interest and Funding Authors stated no financial relationship to disclose.

History prev next Imaging Findings Figure 1: Transverse contrast-enhanced CT image obtained through the midportion of the liver shows a nonoclusive intrahepatic thrombus arrows in the portal branch of the right anterior liver Pylephlebitis ist Thrombophlebitis, causing nonhomogeneus enhancement of the hepatic parenchyma. Discussion Received August 28, ; revision requested September 26; revision received October 15; final version accepted December Email to Pylephlebitis ist Thrombophlebitis Friend.

Multidetector More info Features of Mesenteric Vein Thrombosis. Imaging Assessment of Congenital and Acquired Abnormalities of the Portal Venous System. MR Imaging Evaluation of Abdominal Pain Pylephlebitis ist Thrombophlebitis Pregnancy: Appendicitis and Other Nonobstetric Causes.

CT Appearance of Pyogenic Liver Abscesses Caused by Klebsiella pneumoniae. Comprehensive Approach to Hepatic Vascular Disease. More than Just Typical Acute Appendicitis on Pylephlebitis ist Thrombophlebitis Uncommon Conditions Related to Appendix. The bottom article widget was removed in March The names and locations of the individuals and resident groups, as submitted, are as follows: Individual responses Hisashi Abe, MD, Suita, Osaka, Japan Gholamali Afshang, MD, Tinley Park, Pylephlebitis ist Thrombophlebitis Anjali Agrawal, MBBS, Pylephlebitis ist Thrombophlebitis, India Elisa Aguirre Pascual, Madrid, Spain Harry A.

Zapolsky, MD, Oshkosh, Wis Ahmed Zidan, MD, Barcelona, Spain Resident group responses The Hospital Povista Radiology Residents, Vigo, Spain Hospital Universitario Pylephlebitis ist Thrombophlebitis de Curitiba Radiology Residents, Curitiba, Brazil Naval Medical Center Residents, San Diego, Calif Prince of Songkla University Radiology Residents, Songkla, Thailand University of Pennsylvania Radiology Residents, Philadelphia, Pa Received August 28, ; revision requested September 26; revision received October 15; final version accepted December Sobhonslidsuk AReddy KR.

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