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Updated: Mar 19, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Superior mesenteric vein thrombosis as a complication of cecal diverticulitis: A case report
Soniya Pinto1, Terrence Lerner2, Gowtham Lingamaneni1
1University of Illinois Chicago (Metropolitan Group Hospitals), Department of General Surgery, United States.
Abstract:
Pylephlebitis is an uncommon complication of uncontrolled intra-abdominal infection that is associated with high morbidity and mortality. We present our experience with a unique case of cecal diverticulitis and septic thrombophlebitis of the superior mesenteric vein that was promptly diagnosed with high-resolution imaging and blood cultures. Antibiotic and anticoagulation therapy was instituted on confirming the diagnosis with magnetic resonance imaging (MRI) to control the infection and prevent propagation of the thrombus. Our case report raises awareness about a rare and potentially fatal condition and provides appropriate imaging supplementation to aid in timely diagnosis.
Insights
Pylephlebitis, a rare complication of abdominal infection, can be fatal. Prompt diagnosis via imaging and blood cultures, followed by antibiotics and anticoagulation, is crucial for managing cecal diverticulitis and superior mesenteric vein thrombosis.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Infectious Diseases
Background:
- Pylephlebitis is a rare but severe complication of intra-abdominal infections.
- It involves septic thrombophlebitis of the portal venous system, particularly the superior mesenteric vein.
- High morbidity and mortality rates underscore the need for early diagnosis and treatment.
Purpose of the Study:
- To report a unique case of pylephlebitis secondary to cecal diverticulitis.
- To highlight the role of advanced imaging in prompt diagnosis.
- To emphasize the importance of combined antibiotic and anticoagulation therapy.
Main Methods:
- Case presentation of a patient with cecal diverticulitis and superior mesenteric vein thrombosis.
- Diagnosis confirmed using high-resolution imaging, specifically magnetic resonance imaging (MRI).
- Blood cultures were obtained to identify causative pathogens.
Main Results:
- Successful diagnosis of cecal diverticulitis and septic thrombophlebitis of the superior mesenteric vein.
- Initiation of antibiotic therapy to control infection.
- Commencement of anticoagulation therapy to prevent thrombus propagation.
Conclusions:
- Pylephlebitis, though uncommon, is a critical condition requiring prompt recognition.
- High-resolution imaging modalities like MRI are vital for timely diagnosis.
- A multimodal treatment approach involving antibiotics and anticoagulation is essential for favorable outcomes.
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