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Case Reports
. 2015 Apr 10;2(3):142-5.
doi: 10.14309/crj.2015.35. eCollection 2015 Apr.

Pylephlebitis After Colonic Polypectomy Causing Fever and Abdominal Pain

Zane R Gallinger  1 , Gary May  2 , Paul Kortan  2 , Ahmed M Bayoumi  3
Affiliations
Case Reports

Pylephlebitis After Colonic Polypectomy Causing Fever and Abdominal Pain

Zane R Gallinger et al. ACG Case Rep J. .

Abstract

Pylephlebitis is a rare condition with a high mortality risk if not recognized and treated early. The most common symptoms include fever and abdominal pain, with the majority of cases manifesting with a polymicrobial bacteremia. We report an elderly woman with pylephlebitis presenting with fever, abdominal pain, diarrhea, and vomiting, likely secondary to a polypectomy 6 weeks prior. Abdominal CT revealed portal vein thrombus and blood cultures grew Streptococcus milleri and Haemophilus parainfluenza type V. Pylephlebitis should be considered when symptoms and signs of infection develop following endoscopic procedures, particularly in patients with an underlying hypercoaguable disease.

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Figures

Figure 1
Figure 1
Abdominal CT showing hypoattenuating liver lesions.
Figure 2
Figure 2
Abdominal CT showing a non-occlusive clot in the superior mesenteric vein (black arrow) with hypoattenuating perfusion abnormalities of the liver parenchyma.
See this image and copyright information in PMC

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