TY - JOUR T1 - Rare fatal complication of appendicitis in a child: pylephlebitis JF - World Journal of Pediatric Surgery JO - World Jnl Ped Surgery DO - 10.1136/wjps-2021-000262 VL - 4 IS - 4 SP - e000262 AU - Saloua Ammar AU - Hana Benameur AU - Mahdi Ben Dhaou AU - Emna Daoud AU - Anouar Jarraya AU - Riadh Mhiri Y1 - 2021/09/01 UR - http://wjps.bmj.com/content/4/4/e000262.abstract N2 - An 11-year-old boy without any medical history presented with a 4-day history of vomiting and abdominal pain, followed by appearance of fever and decreased energy. Physical examination showed a blood pressure of 90/60 mm Hg, a pulse rate of 120/min, a temperature of 40°C, oxygen saturation of 93% on air, and diffuse abdominal contracture. Laboratory values showed hyperleukocytosis (24,000/mm3), hemoglobin of 15 g/L, prothrombin time of 48%, and creatinine of 127 mmol/L. An abdominal computed tomography (CT) showed a thick perforated appendix, an abundant intraperitoneal effusion, and pneumoperitoneum. There were air bubbles in the Wirsung canal, parietal pneumatosis of the duodenum and the jejunum, and hepatic portal venous gas (figure 1). Thromboses of the mesenteric vein, splenic vein, and portal vein were suspected due to the CT scan findings. A contrast enhancement study was not performed because of the elevated creatinine. The boy was admitted to the department of pediatric surgery for … ER -