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Perforated diverticulum of the terminal ilenum

A previously unreported cause of suppurative pylephlebitis and multiple hepatic abscesses


We describe the case of a 58-year-old man who presented to the hospital with central abdominal pain, nausea, fever, chills, and dyspnea. While in the hospital, jaundice appeared and the liver function tests revealed features of both cholestasis and hepatocellular injury. He developed gram-negative septicemia and died on the sixth hospital day. Autopsy disclosed a perforated terminal ileal diverticulum and a contiguous mesenteric abscess. These was also severe phlebitis of mesenteric venous radicles which extended superiorly to the intrahepatic portal venules and veins. The portal veins were surrounded by multiple hepatic abscesses that varied in size from microscopic to 2.5 cm. This appears to be the first report in the world literature of suppurative pylephlebitis and hepatic abscesses resulting from a perforated ileal diverticulum. The subject of small bowel non-meckelian diverticulosis is reviewed because of the rarity of this condition and the diagnostic challenges it poses.

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Correspondence to Carlos Navarro MD.

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Navarro, C., Clain, D.J. & Kondlapoodi, P. Perforated diverticulum of the terminal ilenum. Digest Dis Sci 29, 171–177 (1984).

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  • Small Bowel
  • Portal Vein
  • Ileal
  • Liver Function Test
  • Cholestasis