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Updated: May 5, 2026

Multimodality Diagnosis of Mesenteric Ischemia

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Pylephlebitis With Reversible Mesenteric Ischemia in a Patient With Complicated Acute Appendicitis: A Case Report

Marcia Mejía Velásquez¹, Ana M Trujillo Gómez²

¹Radiology, Universidad de Antioquia, Medellín, COL.

|May 4, 2026

Abstract:

Pylephlebitis is a rare complication of intra-abdominal and pelvic infections, occurring in the context of conditions such as acute appendicitis and diverticulitis, among others. It consists of septic thrombophlebitis of the portal vein and/or its tributary branches. Early diagnosis of this condition is crucial to prevent serious complications like sepsis and mesenteric ischemia. Contrast-enhanced abdominal CT scan is the test of choice for diagnosis and for evaluating potential complications, and the correct interpretation of radiological findings is essential to avoid unnecessary interventions. This case report describes an adult patient with pylephlebitis secondary to acute appendicitis and a rare association with mesenteric-colonic ischemia. The patient had a favorable outcome following treatment with antibiotics and anticoagulants, and the ischemia was reversible. The report emphasizes the radiological findings.

Insights

Pylephlebitis, a septic thrombophlebitis of the portal vein, can arise from intra-abdominal infections. Early diagnosis via CT scans is key to managing complications like mesenteric ischemia.

Area of Science:

Internal Medicine
Radiology
Gastroenterology

Background:

Pylephlebitis is a rare but serious complication of intra-abdominal infections.
It involves septic thrombophlebitis of the portal vein and its tributaries.
Prompt diagnosis is vital to prevent severe outcomes such as sepsis and mesenteric ischemia.

Read full analysis

Keywords:

acute appendicitis diagnostic imaging hepatic abscess mesenteric ischemia pylephlebitis

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