Synonym: pyelophlebitis (a misspelling)
Features:
(1)
thrombosis of the portal, splenic and/or mesenteric vein
(2) triggering event (see below)
(3) additional risk factors such as portal hypertension, trauma or hypercoagulable state
(4) variable gas in the portal vein on imaging studies
(5) variable fat stranding around the thrombosed vein on imaging studies
Triggering events:
(1) diverticulitis
(2) appendicitis
(3) ischemic colitis
(4) necrotizing pancreatitis
(5) inflammatory bowel disease
(6) adenocarcinoma
(7) cholecystitis
Bacteria isolated on culture include:
(1) Escherichia coli and other Enterobacteriacea
(2) Streptococcus species
(3) Bacteroides species and other anaerobic bacteria
Complications:
(1) liver abscesses
(2) sepsis
(3) multi-organ failure (MOF)
