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Pylephlebitis due to perforated diverticulitis

C Van De Wauwer1, T T Irvin

  • 1Department of surgery, Royal Devon and Exeter Hospital, Exeter, UK. cvandewauwer@hotmail.com

Acta Chirurgica Belgica
|May 24, 2005
PubMed

Insights

Pylephlebitis, a rare but fatal complication of diverticulitis, can occur from sigmoid perforation. This case highlights successful treatment with antibiotics and surgery.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Pylephlebitis, or septic thrombophlebitis of the portal vein, is a severe complication.
  • It is often associated with intra-abdominal infections, including diverticulitis.
  • Diverticulitis-associated pylephlebitis carries a high mortality rate.

Observation:

  • A case of pylephlebitis secondary to sigmoid colon perforation is presented.
  • The patient presented with symptoms indicative of severe intra-abdominal sepsis.
  • Diagnostic imaging confirmed portal vein thrombosis.

Findings:

  • The patient received broad-spectrum antibiotics to manage the infection.
  • A Hartmann procedure was performed to address the sigmoid perforation.
  • Successful treatment led to recovery and resolution of the pylephlebitis.

Implications:

  • This case underscores the importance of prompt diagnosis and aggressive management of pylephlebitis.
  • Early intervention with antibiotics and surgical source control can be life-saving.
  • Highlights the successful combined approach for managing complicated diverticulitis with pylephlebitis.

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