Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature
Dorde Jevtic, Tatjana Gavrancic, Ivana Pantić, Terri Nordin, Charles W. Nordstrom, Marina Antic, Nikola Pantić, Marija Kaljevic, Bojan Joksimović, Milan Jovanović, Emilia Petcu, Mladen Jecmenica, Tamara Alempijević, Lawrence J. Sprecher, Igor Dumic
Abstract
Suppurative portal vein thrombosis (pylephlebitis) is an uncommon condition usually associated with an intra-abdominal infection or inflammatory process. In this study, we aimed to synthesize data on previously published cases according to the PRISMA guidelines. A total of 103 patients were included. Patients were more commonly male (71.8%) and had a mean age of 49 years. The most common infection associated with pylephlebitis was diverticulitis (n = 29, 28.2%), and Escherichia coli was the most isolated pathogen (n = 21, 20.4%). Blood cultures were positive in 64 cases (62.1%). The most common site of thrombosis was the main portal vein (PV) in 59 patients (57.3%), followed by the superior mesenteric vein (SMV) in 40 patients (38.8%) and the right branch of the PV in 30 patients (29.1%). Sepsis developed in 60 patients (58.3%). The mortality rate in our review was 8.7%, and independent risk factors for mortality were the presence of pertinent comorbidities (OR 5.5, p = 0.02), positive blood cultures (OR 2.2, p = 0.02), and sepsis (OR 17.2, p = 0.049).