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Case Reports
. 2013 Jul 5;3(2).
doi: 10.3402/jchimp.v3i2.20732. Print 2013.

Pylephlebitis: a rare complication of an intra-abdominal infection

Katherine Wong  1 , David S Weisman, Kelly-Ann Patrice
Affiliations
Case Reports

Pylephlebitis: a rare complication of an intra-abdominal infection

Katherine Wong et al. J Community Hosp Intern Med Perspect. .

Abstract

Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition.

Keywords: abdominal infection; appendicitis; bacteroides; diverticulitis; portal vein thrombosis; pylephlebitis; sepsis.

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Figures

Fig. 1
Fig. 1
Contrast enhanced CT of the abdomen showing a nonocclusive thrombus within the main portal vein (white arrow).
Fig. 2
Fig. 2
Contrast enhanced CT of the abdomen showing a focal 3.2-cm mass (white arrow) adjacent to the ileocecal valve along the mesenteric border with central fat attenuation and surrounding soft tissue attenuation suggesting epiploic appendicitis or a fatty infarct.
Fig. 3
Fig. 3
Contrast-enhanced CT of the abdomen on hospital day 7 showing resolution of the ileocecal mass.
See this image and copyright information in PMC

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