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Journal of Gastrointestinal Surgery

, Volume 20, Issue 3, pp 656–661 | Cite as

Pylephlebitis: a Review of 95 Cases

  • Asad J. Choudhry
  • Yaser M. K. Baghdadi
  • Mahmoud A. Amr
  • Mohammad J. Alzghari
  • Donald H. Jenkins
  • Martin D. ZielinskiEmail author
Review Paper

Abstract

Pylephlebitis, or suppurative thrombophlebitis of the portal mesenteric venous system occurring in the setting of abdominal inflammatory processes, is a rare but deadly disease commonly associated with diverticulitis. We review our institutional experience in the management of patients with this condition. A retrospective review of medical records from 2002 to 2012 was performed. Patients with a portal mesenteric vein thrombosis (PMVT) within 30 days of an intra-abdominal inflammatory process were identified and evaluated. Ninety-five patients were included. The mean patient age at presentation was 57 years (range, 24–88). The most common associated processes were pancreatitis (31 %), followed by diverticulitis (19 %). Bacteremia was noted in 34 (44 %) patients. The most common organism cultured was Streptococcus viridans. Antibiotic and anticoagulation therapy was given in 86 (91 %) and 78 (82 %) patients, respectively. Overall, we report an 11 % mortality rate. Albeit rare, pylephlebitis most commonly was manifested in the setting of pancreatitis. Treatment should be individualized to culture results and extent of thrombosis. If diagnosed early and managed appropriately, a favorable outcome is possible.

Keywords

Mesenteric thrombosis Pancreatitis Portal vein thrombosis Pylephlebitis Sepsis 

Notes

Disclosures

This publication was made possible by CTSA Grant Number UL1 TR000135 and KL2 TR000136 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Asad J. Choudhry
    • 1
  • Yaser M. K. Baghdadi
    • 1
  • Mahmoud A. Amr
    • 1
  • Mohammad J. Alzghari
    • 1
  • Donald H. Jenkins
    • 1
  • Martin D. Zielinski
    • 1
    • 2
    Email author
  1. 1.Department of SurgeryMayo ClinicRochesterUSA
  2. 2.Division of Trauma, Critical Care, and General SurgeryRochesterUSA

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