Acute infective portal vein thrombosis secondary to acute sigmoid diverticulitis

Antonio Ricardo Cheesman, Anas Gremida, Mary Burton


Infective thrombosis of the portal vein may complicate any infectious process of the abdominal portion of the gastrointestinal tract. The diagnosis requires a high index of suspicion, and the most common findings include fever, abdominal pain and abnormal liver function tests. Abdominal CT scan is the preferred diagnostic modality. Treatment should be initiated immediately, including empiric use of antibiotics and concomitant anticoagulation in view of the high mortality rate.



Portal vein thrombosis; Pylephlebitis; Diverticulitis



Baril, N., et al., The role of anticoagulation in pylephlebitis. Am J Surg, 1996. 172(5): p. 449-52; discussion 452-3.

Plemmons, R.M., D.P. Dooley, and R.N. Longfield, Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis, 1995. 21(5): p. 1114-20.

Waxman, B.P., L.L. Cavanagh, and J. Nayman, Suppurative pyephlebitis and multiple hepatic abscesses with silent colonic diverticulitis. Med J Aust, 1979. 2(7): p. 376-8.

Saxena, R., et al., Pylephlebitis: a case report and review of outcome in the antibiotic era. Am J Gastroenterol, 1996. 91(6): p. 1251-3.

Chang, Y.S., et al., Septic thrombophlebitis of the porto-mesenteric veins as a complication of acute appendicitis. World J Gastroenterol, 2008. 14(28): p. 4580-2.

Vivas, I., et al., Combination of various percutaneous techniques in the treatment of pylephlebitis. J Vasc Interv Radiol, 2000. 11(6): p. 777-80.

Condat, B., et al., Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology, 2000. 32(3): p. 466-70.

Kanellopoulou, T., et al., Pylephlebitis: an overview of non-cirrhotic cases and factors related to outcome. Scand J Infect Dis, 2010. 42(11-12): p. 804-11.

Kasper, D.L., D. Sahani, and J. Misdraji, Case records of the Massachusetts General Hospital. Case 25-2005. A 40-year-old man with prolonged fever and weight loss. N Engl J Med, 2005. 353(7): p. 713-22.

Pelsang, R.E., et al., Management of suppurative pylephlebitis by percutaneous drainage: placing a drainage catheter into the portal vein. Am J Gastroenterol, 2001. 96(11): p. 3192-4.

Duffy, F.J., Jr., et al., Suppurative pylephlebitis and pylethrombosis: the role of anticoagulation. Am Surg, 1995. 61(12): p. 1041-4.

Nishimori, H., et al., Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case. Surg Today, 2004. 34(2): p. 173-6.

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