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Gen
Print version ISSN 0016-3503On-line version ISSN 2477-975X
Abstract
MALDONADO, Mariant; DE ANDRADE, Yuraima Patricia; DIAZ, Marisela and DE SOUSA URDANETA, Katherine. Pilephlebitis as a complication of cholangitis and acute cholecystitis. Gen [online]. 2025, vol.79, n.1, pp.51-58. Epub Mar 09, 2025. ISSN 0016-3503. https://doi.org/10.61155/gen.v79i1.733.
Pylephlebitis is defined as an infectious thrombosis of the portal vein or its branches. This rare condition arises as a consequence of intra abdominal or pelvic infections in areas drained by the portal venous circulation or adjacent to it. The most common causes are appendicitis and acute diverticulitis, affecting patients across a broad age range, from 20 days to 77 years, with a mean age of 42 years.
Clinical Case:
A 77 year-old male patient presented with abdominal pain localized to the right hypochondrium, fever, and jaundice. Laboratory tests revealed leukocytosis and alterations in the hepatobiliary profile suggestive of obstructive biliary pathology. Abdominal ultrasound showed a gallbladder with thickened walls, biliary sludge, dilation of the main bile duct, choledocholithiasis, and a dilated extrahepatic portal vein containing echogenic material in its right branch with poor flow detected on color Doppler. Additional imaging studies, including Doppler ultrasound of the spleno-portal axis and contrast-enhanced abdominal and pelvic CT, confirmed dilation of the main bile duct secondary to choledocholithiasis and thrombosis of the right portal vein. A clinical diagnosis of pylephlebitis secondary to acute cholangitis and acute cholecystitis was established.
Discussion:
Cholangitis and acute cholecystitis have been reported as uncommon causes of pylephlebitis due to infections adjacent to the portal venous system.
Conclusion:
Pylephlebitis is a rare condition that develops as a complication of intra abdominal or pelvic infections.
Keywords : Cholangitis; Infectious thrombosis; Portal Vein.
