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Diverticulitis complicated by pylephlebitis: A case report

Gajendran, M and Muniraj, T and Yassin, M (2011) Diverticulitis complicated by pylephlebitis: A case report. Journal of Medical Case Reports, 5.

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Introduction. Pylephlebitis is defined as septic thrombophlebitis of the portal venous system, usually secondary to infection or inflammation in the abdomen. In the current report, we present a case of pylephlebitis that complicated the course of a very common pathology, diverticulitis. Case presentation. A 62-year-old Caucasian woman with a history of sigmoid diverticulitis presented to our facility with a three-week history of abdominal pain, fevers, chills, loss of appetite and fatigue. Her laboratory test results showed leukocytosis and elevated alkaline phosphatase. A computed tomography scan revealed portal vein thrombosis and a sigmoid diverticulitis with an abscess. Our patient was given pipercillin-tozabactam followed by sigmoid colectomy and loop transverse colostomy. A peritoneal fluid sample culture grew Escherichia coli. Our patient had an uneventful post-operative course and the leukocytosis resolved in the next four days. She improved clinically and was discharged home on ertapenem and enoxaparin. A follow-up computed tomography scan two weeks later showed a new pelvic abscess that was drained by a pigtail catheter but there was no change in the portal venous thrombus. A repeat computed tomography scan one month later revealed resolution of the pelvic abscess but persistence of portal vein thrombus, for which enoxaparin was continued. Conclusions: This is a classic case of pylephlebitis that demonstrates the importance of recognizing that the portal vein thrombus is infected and treating the condition appropriately. © 2011Gajendran et al; licensee BioMed Central Ltd.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Gajendran, Mmag157@pitt.eduMAG157
Muniraj, T
Yassin, MMHY8@pitt.eduMHY8
Date: 11 October 2011
Date Type: Publication
Journal or Publication Title: Journal of Medical Case Reports
Volume: 5
DOI or Unique Handle: 10.1186/1752-1947-5-514
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Date Deposited: 26 Oct 2016 16:49
Last Modified: 25 Jun 2022 13:55


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