Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess

dc.contributor.authorPitcher, Richard
dc.contributor.authorMcKenzie, Carey
dc.date.accessioned2016-03-18T07:37:07Z
dc.date.available2016-03-18T07:37:07Z
dc.date.issued2003
dc.date.updated2015-12-21T11:05:11Z
dc.description.abstractA 17-year-old youth from a rural background presented to a secondary hospital with a 3-week history of epigastric pain, constipation and weight loss. He had a temperature of 40°C, marked right upper quadrant tenderness and a white cell count of 21.1 ´ 109/l. The chest and abdominal radiographs were normal, but an abdominal ultrasound scan showed two small areas of low echogenicity in the left lobe of the liver consistent with abscesses (Fig. 1). The main portal vein was distended, measuring 16 mm in diameter, and contained echogenic material indicative of thrombus (Fig. 2). In the right iliac fossa there were features of an inflamed appendix, as demonstrated by an 8 mm diameter tubular, non-compressible, fluid-filled viscus, with a distal blind end and an echogenic focus filling the lumen proximally (Fig. 3). A diagnosis was made of acute appendicitis, complicated by septic thrombophlebitis of the portal vein (pylephlebitis) and pyogenic liver abscesses. Appendicectomy was performed later that day, revealing an inflamed appendix, confirmed histologically. The patient was treated with perioperative intravenous triple antibiotics and commenced on anticoagulants following surgery. Discharge was on the 10th postoperative day. Regular out-patient follow-up documented progressive decrease in the size of the portal vein thrombus and the liver abscesses. The abdominal ultrasound scan 4 months post-surgery demonstrated a completely normal upper abdomenen_ZA
dc.identifier.apacitationPitcher, R., & McKenzie, C. (2003). Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/17981en_ZA
dc.identifier.chicagocitationPitcher, Richard, and Carey McKenzie "Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess." <i>South African Medical Journal</i> (2003) http://hdl.handle.net/11427/17981en_ZA
dc.identifier.citationPitcher, R. & McKenzie, C. A.. (2003). Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess, 93(6): 426-428en_ZA
dc.identifier.issn0256-9574en_ZA
dc.identifier.ris TY - Journal Article AU - Pitcher, Richard AU - McKenzie, Carey AB - A 17-year-old youth from a rural background presented to a secondary hospital with a 3-week history of epigastric pain, constipation and weight loss. He had a temperature of 40°C, marked right upper quadrant tenderness and a white cell count of 21.1 ´ 109/l. The chest and abdominal radiographs were normal, but an abdominal ultrasound scan showed two small areas of low echogenicity in the left lobe of the liver consistent with abscesses (Fig. 1). The main portal vein was distended, measuring 16 mm in diameter, and contained echogenic material indicative of thrombus (Fig. 2). In the right iliac fossa there were features of an inflamed appendix, as demonstrated by an 8 mm diameter tubular, non-compressible, fluid-filled viscus, with a distal blind end and an echogenic focus filling the lumen proximally (Fig. 3). A diagnosis was made of acute appendicitis, complicated by septic thrombophlebitis of the portal vein (pylephlebitis) and pyogenic liver abscesses. Appendicectomy was performed later that day, revealing an inflamed appendix, confirmed histologically. The patient was treated with perioperative intravenous triple antibiotics and commenced on anticoagulants following surgery. Discharge was on the 10th postoperative day. Regular out-patient follow-up documented progressive decrease in the size of the portal vein thrombus and the liver abscesses. The abdominal ultrasound scan 4 months post-surgery demonstrated a completely normal upper abdomen DA - 2003 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2003 SM - 0256-9574 T1 - Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess TI - Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess UR - http://hdl.handle.net/11427/17981 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/17981
dc.identifier.vancouvercitationPitcher R, McKenzie C. Simultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscess. South African Medical Journal. 2003; http://hdl.handle.net/11427/17981.en_ZA
dc.languageengen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_ZA
dc.sourceSouth African Medical Journalen_ZA
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleSimultaneous ultrasound identification of acute appendicitis, septic thrombophlebitis of the portal vein and pyogenic liver abscessen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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