|ECR 2012 / C-2254|
|PYLEPHLEBITIS: LESS COMMON CAUSES. Nº 835.|
|This poster was previously presented in Spanish at the 2010 Congreso Nacional SERAM (A Coruña)|
We define portal pylephlebitis as a septic thrombosis of the portal vein or its branches (Fig. 1 a y b y fig. 5).
It is an uncommon pathology with high mortality as a result of inflammatory intraabdominal processes, including colic diverticulitis, necrotizing pancreatitis, hemorrhoidal disease, open abdominal traumatism, ileal diverticula, acute cholecystitis, amoebic colitis and inflammatory bowel disease.
Of all these etiologies, until recently, the most common cause that produced it was acute appendicitis, currently the most common etiology is documented colonic diverticulitis.
In this section, we show 3 cases diagnosed in our department with an unusual etiology, two of them were secondary to acute cholecystitis (Fig. 2 a, b y c y fig. 4 a, b, c y d) and the other was secondary to necrotizing pancreatitis (Fig. 3 a y b), which was complicated with multiple hepatic abscesses latter (Fig. 3 c y d).
We can diagnose portal vein thrombosis with US or CT-enhancement exam; however due to the capability of CT for give de diagnosis and the causes of this pathology, abdominal CT-enhancement in arterial and portal phases is the technique of choice for diagnosis.
The treatment of this condition is the cause of the inflammatory process while the indication for anticoagulation is controversial.
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