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Pylethrombosis. Serendipitous radiologic diagnosis.

J M Harch¹, R D Radin, A E Yellin

¹Department of Surgery, University of Southern California, Los Angeles.

Archives of Surgery (Chicago, Ill. : 1960)

|October 1, 1987

Summary

Pylethrombosis, or portal vein thrombosis, can be unexpectedly found using CT scans and ultrasound. Early diagnosis and anticoagulation are crucial for preventing complications like bowel ischemia.

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Area of Science:

Vascular Surgery
Diagnostic Imaging
Gastroenterology

Background:

Pylethrombosis involves blood clots in the portal vein or its branches.
It can be associated with abdominal sepsis, cholecystitis, or hypercoagulable states.

Observation:

Five cases of pylethrombosis were incidentally diagnosed.
Computed tomography (CT) identified four cases, and ultrasonography identified one case.
Associated conditions included abdominal sepsis, choledocholithiasis, and mesenteric venous thrombosis.

Findings:

Advanced imaging like CT and ultrasound can reveal unsuspected pylethrombosis.
Severe cases may necessitate surgical intervention due to peritonitis or enteric ischemia.
Anticoagulation therapy is recommended for acute portal or mesenteric venous thrombosis.

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Implications:

Improved detection of pylethrombosis with modern imaging techniques.
Timely anticoagulation can prevent disease progression and complications.
Prompt surgical evaluation is vital for patients with signs of ischemia or sepsis.