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[Phylephebitis due to diverticulitis].

S Casallo Blanco1, A I Muñoz Ruiz, F Marcos Sánchez

  • 1Servicio de Medicina Interna, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo.

Anales De Medicina Interna (Madrid, Spain : 1984)
|March 21, 2007
PubMed
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This case study details a 52-year-old male experiencing abdominal pain due to infective suppurative thrombosis of the portal vein, a rare complication of acute diverticulitis. Treatment involved surgery, antibiotics, and anticoagulation, leading to a favorable outcome.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Diverticulitis is a common condition, but its complications can be severe and varied.
  • Portal vein thrombosis is a rare but serious complication, often associated with abdominal sepsis.
  • This case highlights an unusual presentation of diverticulitis leading to pylephlebitis.

Observation:

  • A 52-year-old male presented with abdominal pain, fever, and abnormal liver function tests.
  • Imaging revealed hepatomegaly, splenomegaly, and extensive thrombosis of the inferior mesenteric, splenic, and portal veins.
  • Surgical exploration confirmed acute diverticulitis complicated by infective suppurative pylephlebitis.

Findings:

  • The patient underwent inferior mesenteric vein ligation and a Hartmann procedure for sigmoid colon resection.

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  • Post-operative management included antibiotics and anticoagulation therapy.
  • A favorable clinical outcome was achieved with the combined treatment approach.

    • Implications:

    • This case underscores the importance of considering rare complications like pylephlebitis in patients with severe diverticulitis.
    • Early diagnosis and multidisciplinary management are crucial for improving outcomes in such cases.
    • Further research into the specific risk factors and optimal treatment strategies for diverticulitis-associated pylephlebitis may be warranted.