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March 12, 1938


JAMA. 1938;110(11):816-817. doi:10.1001/jama.1938.02790110042012

Pylephlebitis as a cause of mortality in acute appendicitis receives but scant mention in recent statistics. The severe pathologic conditions of the appendix and the surrounding structures, which constitute as a rule the necessary antecedents for thrombotic infection of the portal vein, are seldom observed in the early operations for acute appendicitis which are the rule today. Because of the generally fatal character of this complication if left untreated, it should not, however, be entirely disregarded in considering the mortality of acute appendicitis.

The postmortem statistics of the earlier investigators (Fitz, Armstrong) indicate that the incidence of pylephlebitis and liver abscess in patients who died from appendicitis varied from 3 to 5 per cent. According to Colp,1 among 2,841 patients admitted to Mount Sinai Hospital of New York between 1916 and 1925 the diagnosis of pylephlebitis of appendicular origin was made nine times (about 0.3 per cent). In a