Ileocolic venous thrombophlebitis from associated enteropathogenic E. coli infection

Enteropathogenic Escherichia coli (EPEC) is a pathogenic strain of E. coli. Mesenteric vein thrombophlebitis is of surgical concern, as there is a risk of the development of bowel ischemia. We present a unique case of a patient with EPEC diarrhea who subsequently developed ileocolic thrombophlebitis. Our patient presented to the emergency department with 6 days of diarrhea and abdominal pain. A computed tomography angiography (CTA) abdomen and pelvis was performed which revealed occlusion of the ileocolic vein with perivenous inflammation, consistent with mesenteric thrombophlebitis. A gastrointestinal polymerase chain reaction (GI PCR) was positive for EPEC. The patient was managed non-operatively with intravenous antibiotics and anticoagulation with resolution of symptoms. Ileocolic thrombophlebitis is a rare cause of acute abdominal pain. Our patient is one of the first documented cases to develop thrombophlebitis following EPEC infection. We hypothesize the EPEC infection and inflammation predisposed our patient to developing ileocolic thrombophlebitis.