The Teaching Point

Pylephlebitis is rare and usually occurs as a complication of a common intra-abdominal infection, e.g. diverticulitis or appendicitis. The associated mortality rate is approximately 25%. Therefore, assessment of the intra-abdominal veins should routinely be done when interpreting abdominal CT images; the clot causes a central filling defect and a peripherally contrasted vein on enhanced images.






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From the manuscript

Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis

Free full text article: Pylephlebitis of a variant mesenteric vein  complicating sigmoid diverticulitis

Abstract
Pylephlebitis - suppurative thrombophlebitis of the portal and/or mesenteric veins - is a rare complication of abdominal infections, especially diverticulitis. It can lead to severe complications such as hepatic abscess, sepsis, peritonitis, bowel ischemia, etc., which increase the mortality rate. Here we present a case of suppurative thrombophlebitis of the inferior mesenteric vein, as a complication of sigmoid diverticulitis. The epidemiology, clinical and radiological features as well as treatment strategies are discussed. We also review the anatomy of the mesenteric vein given its anatomic variation in the present case and how this anatomic knowledge might influence the operative approach should surgery be necessary.






References



1. Bagot CN, Arya R. Virchow and his triad: a question of attribution. Br J Haematol 2008 143(2): p 180-90
Get full text
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2. Nobili C, Uggeri F, Romano F. Pylephlebitis and mesenteric thrombophlebitis in sigmoid diverticulitis: medical approach, delayed surgery. Dig Liver Dis 2007 39(12): p 1088-90
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


3. Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era. Clin Infect Dis 1995 21(5): p 1114-20
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


4. Coralnick JR, Budin JA, Sedarat A. Inferior mesenteric vein thrombosis in Crohn`s disease: CT diagnosis. J Comput Assist Tomogr 1996 20(1): p 168-9
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


5. Sillero JM, Calvet X, Musulen E. Idiopathic pylephlebitis and idiopathic sclerosing peritonitis in a man with protein S deficiency. J Clin Gastroenterol 2001 32(3): p 262-5
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


6. Lee BK, Ryu HH. A case of pylephlebitis secondary to cecal diverticulitis. J Emerg Med 2012 42(4): p e81-5
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


7. Mailleux P, Maldague P, Coulier B. Pylephlebitis complicating peridiverticulitis without hepatic abscess: early detection with contrast-enhanced CT of the abdomen. JBR-BTR 2012 95(1): p 13-4
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


8. Kanellopoulou T, Alexopoulou A, Theodossiades G. Pylephlebitis: an overview of non-cirrhotic cases and factors related to outcome. Scand J Infect Dis 2010 42(11-12): p 804-11
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


9. Baril N, Wren S, Radin R. The role of anticoagulation in pylephlebitis. Am J Surg 1996 172(5): p 449-52; discussion 452-3
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


10. Sj÷bring U, Ringdahl U, Ruggeri ZM. Induction of platelet thrombi by bacteria and antibodies. Blood 2002 100(13): p 4470-7
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


11. Kasper DL, Sahani D, Misdraji J. Case records of the Massachusetts General Hospital. Case 25-2005 A 40-year-old man with prolonged fever and weight loss
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


12. Balthazar EJ, Gollapudi P. Septic thrombophlebitis of the mesenteric and portal veins: CT imaging. J Comput Assist Tomogr 2000 24(5): p 755-60
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


13. Nishimori H, Ezoe E, Ura H. 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
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


14. Kaewlai R, Nazinitsky KJ. Acute colonic diverticulitis in a community-based hospital: CT evaluation in 138 patients. Emerg Radiol 2007 13(4): p 171-9
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


15. Molitch HI. Septic thrombophlebitis of the inferior mesenteric vein complicating sigmoid diverticulitis: CT findings. AJR Am J Roentgenol 1996 167(4): p 1014-6
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


16. Shapir J, Rubin J. CT appearance of the inferior mesenteric vein. J Comput Assist Tomogr 1984 8(5): p 877-80
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


17. Krumm P, Schraml C, Bretschneider C. Depiction of variants of the portal confluence venous system using multidetector row CT: analysis of 916 cases. Rofo 2011 183(12): p 1123-9
Get full text
Find similar topics on Read this article on PubMed :: Find similar articles on Google scholarScholar :: Search for similar topics with the Radiology specific search engine Radiology search engine


18. Heye T, Bernhard M, Mehrabi A. Portomesenteric venous gas: Is gas distribution linked to etiology and outcome? Eur J Radiol 2012.
Get full text
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19. Baer HM, Siegelbaum MH, Seidmon EJ. Venous intravasation of barium into the inferior mesenteric vein mimicking a coloureteral fistula: a case report and literature review. J Urol 1989 141(1): p 117-9
Get full text
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20. Verde F, Johnson PT. One not to miss: ovarian vein thrombosis causing pulmonary embolism with literature review. J Radiol Case Rep 2012 6(9): p 23-8
Get full text
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