Journals on Medical Microbiology - BJSTR Journal

Abstract

Background: #Sigmoid diverticulitis is a common #abdominal disease that may require emergency treatment. The prognosis depends on the potentially dangerous complications, in particular #pylephlebitis and #hepatic abscess.

Case Report: We report the case of a patient with sigmoid diverticulitis, due to the ingestion of a foreign body, impacted in a diverticulum, complicated by pylephlebitis and hepatic abscess. The patient was treated by endoscopic extraction of the foreign body, antibiotic therapy and #anticoagulation. Evolution was favorable. Sigmoid diverticulitis is one of the most common abdominal diseases requiring emergency treatment in Western countries. Conservative medical treatment often leads to the regression of symptoms, but some complications can be life threatening. Septic dissemination by contiguity (peri-intestinal abscesses/ generalized peritonitis) or hematogenous (pylephlebitis/hepatic abscess) may occur [1]. The suspicion of complications is based on clinical signs and symptoms (#hyperthermia, abdominal pain, sometimes the presence of a palpable abdominal mass), and on blood tests showing an inflammatory response. However, the gold standard for the diagnosis is abdomino-pelvic computed tomography (CT) with injection of an iodinated contrast agent. A CT-scan is superior to ultrasound and magnetic resonance imagery for the visualization of deep #intra-abdominal abscesses and #septic thromboses due to its better spatial resolution and its greater acquisition range [2].

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Pylephlebitis and Liver Abscess Complicating #Diverticulitis by Chassang Madlee in BJSTR