Pylephlebitis secondary to diverticulitis

Ignacio Cconchoy F.L.; Baella Á.C.; Ayllaucan Sánchez M.D.; Julián Maldonado A.M.; Cervera Caballero L.E. · Medicina Interna de Mexico (2025) · DOI: 10.24245/mim.v1icc_julio.10227

Resumen

BACKGROUND: Pylephlebitis is an uncommon condition with an incidence of 2.7 cases per 100,000 inhabitants and can complicate any intra-abdominal or pelvic infection, being mainly secondary to diverticulitis. CLINICAL CASE: A 56-year-old female patient who attended a hospital in Lima, Peru, due to abdominal pain, fever and leukocytosis. Contrast tomography showed thrombus in portal and mesenteric vein, as well as signs of acute diverticulitis, and subsequent colonoscopy showed diverticulosis. The patient was treated with antibiotics and anticoagulation and the evolution was favorable. CONCLUSION: This case highlights the importance of having a high clinical suspicion of pylephlebitis together with a timely request for imaging in patients with abdominal pain and fever, which reduces morbidity and mortality rates.

Instituciones: Universidad San Ignacio de Loyola