Treatment of portal vein septic thrombosis by infusion of antibiotics and an antifungal agent into portal vein and superior mesenteric artery: a case report

Abstract

A 44-year-old man was hospitalized because of right-sided abdominal pain and fever. On admission, he presented spike fever, jaundice, and renal failure. Abdominal ultrasonography and computed tomography showed extensive thrombus in the portal vein. Anaerobic bacteria were identified in arterial and portal blood cultures. Based on these findings, septic thrombosis of the portal vein was diagnosed. Intraportal infusion of antibiotics, urokinase and an antifungal agent, followed by infusion of antimicrobials, urokinase, and heparin into the superior mesenteric artery resulted in marked improvement of symptoms and signs. Diverticulitis of the ascending colon was later found to be the underlying disease. In the follow-up, there were no signs of recurrent disease.