A case of pylephlebitis secondary to cecal diverticulitis

J Emerg Med. 2012 Apr;42(4):e81-5. doi: 10.1016/j.jemermed.2009.02.039. Epub 2009 May 13.

Abstract

Background: Pylephlebitis, which has high rates of morbidity and mortality, is thrombosis in the hepatic and portal veins. Hypercoagulability and intra-abdominal sepsis can lead to pylephlebitis, which can progress to liver abscess, mesenteric ischemia, and infarction.

Case report: A 47-year-old man presented to the Emergency Department complaining of fever, epigastric pain, and jaundice. He was diagnosed with pylephlebitis secondary to diverticulitis, as well as having a diverticular abscess, and was treated with antibiotic therapy without surgery or anticoagulation.

Conclusion: Early diagnosis is essential for the treatment of pylephlebitis. Antibiotics and anticoagulants are the mainstay of treatment for pylephlebitis; although the use of anticoagulants remains controversial. In the present case, pylephlebitis was treated successfully without anticoagulants.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cecal Diseases / complications*
  • Diverticulitis / complications*
  • Hepatic Veins*
  • Humans
  • Male
  • Middle Aged
  • Phlebitis / etiology*
  • Portal Vein*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents