Percutaneous drainage for suppurative pylethrombophlebitis developing in a patient with chronic pancreatitis

Abstract

Suppurative pylethrombophlebitis is an extremely rare disease with high mortality. It is difficult to diagnose this disease because its nonspecific clinical features are unfamiliar to physicians. A 64-year-old Asian man, who had undergone a longitudinal pancreaticojejunostomy for alcoholic chronic pancreatitis 7 years before, had right upper abdominal pain and high fever. Abdominal sonography and contrast-enhanced abdominal computed tomography detected thrombus and fluid collection in the portal vein. After a percutaneous needle puncture, the patient was diagnosed as having suppurative pylethrombophlebitis and treated with only drainage and antibiotics; no operation was required. This case suggests that minimally invasive percutaneous needle puncture of the intrahepatic portal vein may be an accurate procedure for the appropriate diagnosis and treatment of suppurative pylethrombophlebitis.