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Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

World Journal of Hepatology 2019年第1期11卷 133-137页

作者： Charlotte Maulat Léopoldine Lapierre isabelle migueres Xavier Chaufour Guillaume Martin-Blondel Fabrice Muscari Digestive Surgery Toulouse UniversityHospital Department of Infectious and Tropical Diseases Toulouse-Purpan University Hospital Vascular Surgery Department Toulouse-Rangueil University Hospital

BACKGROUND Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a *** SUMMARY This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy,the patient's condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this *** Septic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.

关键词： Bilioma Septic thrombophlebitis Septicaemia Parietal peritoneum tube graft Complete caval reconstruction Case report

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