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Acute pylephlebitis secondary to perforated sigmoid diverticulitis: A case report
Luqman Wali1, Ali Shah2, Stefan Sleiman3
1Medway NHS Foundation Trust, Kent, UK.
Radiology Case Reports
|May 13, 2021
Summary
Pylephlebitis, a rare condition involving portal vein thrombosis, can arise from abdominal infections. Early diagnosis through imaging like CT scans is crucial for reducing severe complications and mortality.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Infectious Diseases
Background:
- Pylephlebitis is defined as portal venous thrombosis secondary to intra-abdominal infection or inflammation.
- Intra-abdominal sepsis presents a diagnostic challenge, with pylephlebitis being a rare but serious complication.
Observation:
- A 69-year-old male presented with nonspecific abdominal pain, rigors, and abnormal liver function tests.
- Initial ultrasound was negative; however, computed tomography (CT) scanning revealed perforated diverticulitis and portal venous system thrombus.
Findings:
- Computed tomography (CT) is essential for diagnosing pylephlebitis, especially when initial ultrasound is inconclusive.
- The case highlights the association between perforated diverticulitis and the development of portal venous thrombosis.
Implications:
- Prompt diagnosis and management of pylephlebitis are critical for improving patient outcomes.
- This case underscores the importance of evaluating the portal venous system in patients with intra-abdominal sepsis to rule out pylephlebitis.
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