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Pylephlebitis complicating acute calculous cholecystitis: A case report.

Ibrahima Faye¹, Abdourahmane Ndong², Adja Coumba Diallo²

¹Department of Radiology, Regional Hospital of Saint Louis du Sénégal, Saint Louis, Senegal.

Radiology Case Reports

|March 17, 2023

Summary

Pylephlebitis, a rare complication of intra-abdominal infections, can occur with cholecystitis. This case highlights a favorable outcome with antibiotics for septic portal vein thrombosis secondary to acute cholecystitis.

Keywords:

Abdominal CT Cholecystitis Pylephlebitis

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Area of Science:

Gastroenterology
Vascular Surgery

Background:

Pylephlebitis, or septic thrombophlebitis of the portal venous system, is a rare but serious complication of intra-abdominal infections.
While often associated with appendicitis or diverticulitis, its occurrence secondary to cholecystitis is exceptionally uncommon.

Observation:

A 43-year-old female presented with symptoms suggestive of an intra-abdominal infection.
Abdominal computed tomography (CT) revealed acute calculous cholecystitis and septic thrombosis of the right portal vein branch.

Findings:

The patient received antibiotic therapy, leading to a favorable clinical response.
Surgical management with cholecystectomy was planned following initial medical treatment.

Implications:

This case underscores the importance of considering pylephlebitis in the differential diagnosis of intra-abdominal infections, even in the context of cholecystitis.
Prompt diagnosis and appropriate antibiotic management are crucial for favorable outcomes in pylephlebitis.