Pileflebitis Asociado A Absceso de Psoas Iliaco en Adulto Mayor

Abstract

Pylephlebitis of intraabdominal infectious origin (psoas abscess) in the elderly is rare. It is defined as septic thrombophlebitis of the portal vein and superior mesenteric, considered a complication for any infectious focus is intra-abdominal or pelvic drained by the branches of the portal venous system is triggered. The case of a male patient of 68 years with a clinical picture of 15-day history of fever, abdominal pain and bloating, jaundice, edema of the left thigh and lumbar region ipsilateral mass is presented. Abdominal radiography at admission showed an obstructive pattern of small intestine; ultrasound revealed purulent soft tissue and muscles of the left lower back. Surgical drainage of the collection was made and subsequently CT abdomen and pelvis in which iliopsoas muscle abscess, which then opens spontaneously into abdominal cavity was shown. Septic condition of the patient from admission required ICU management, its evolution was not satisfactory; pylephlebitis a dialog with intrahepatic abscesses refractory to treatment was started. He remained hospitalized in unstable condition, family requested discharge; patient died at home after a few days. In 1990, mortality was 70%, today it is 25% thanks to technological advances in imaging and antibiotic therapy. However in rural and limited economic capacity areas access to these resources remains a challenge