Pylephlebitis as a Rare Complication of Ulcerative Colitis: A Case Report

Pylephlebitis is a rare and potentially fatal complication of many common abdominal pathologies. Here we describe an unusual case of pylephlebitis associated with ulcerative colitis. A 51-year-old male with a history of ulcerative colitis, diabetes mellitus, and chronic obstructive pulmonary disease (COPD) presented for shortness of breath, fevers, chills, and generalized weakness. The patient was discharged one week prior to this admission after being treated for an acute colitis flare and adverse reaction to sulfasalazine. The current admission was significant for fever, leukocytosis, and lactic acidosis and a portal vein thrombus seen on computed tomography scan. The presentation of sepsis and portal thrombus were consistent with pylephlebitis and he was subsequently started on antibiotics and anticoagulated. He was discharged home and made a full recovery.  Here we present a unique case of pylephlebitis associated with ulcerative colitis. Ultimately this case report serves as a good reminder to stay diligent and keep a broad differential diagnosis when treating a septic patient.