Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis

Authors

  • Anna L. Falkowski
  • Gieri Cathomas
  • Andreas Zerz
  • Helmut Rasch
  • Philip E. Tarr

DOI:

https://doi.org/10.3941/jrcr.v8i2.1698

Keywords:

pylephlebitis, mesenteric thrombosis, mesenteric vein variant, inferior mesenteric vein, sigmoid diverticulitis, CT

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.

Author Biographies

Anna L. Falkowski

Department of Radiology and Nuclear Medicine, Kantonsspital Baselland, 4101 Bruderholz, Switzerland

Gieri Cathomas

Cantonal Institute of Pathology, Kantonsspital Baselland, 4410 Liestal, Switzerland

Andreas Zerz

Department of surgery, Kantonsspital Baselland, 4101 Bruderholz, Switzerland

Helmut Rasch

Department of Radiology and Nuclear Medicine, Kantonsspital Baselland, 4101 Bruderholz, Switzerland

Philip E. Tarr

Infectious Diseases Service, Kantonsspital Baselland, University of Basel, 4101 Bruderholz, Switzerland

Published

2014-02-22

Issue

Section

Gastrointestinal Radiology