Pylethrombosis. Serendipitous radiologic diagnosis
J. M. Harch, R. D. Radin, A. E. Yellin and A. J. Donovan
Department of Surgery, University of Southern California, Los Angeles.
Pylethrombosis is thrombosis of the portal vein or any of its branches.
Five cases have been serendipitously detected, four by computed tomography
and one by ultrasonography. Two patients had abdominal sepsis. A third
patient had apparent acute cholecystitis with choledocholithiasis. The last
two patients had a hypercoagulable state, mesenteric venous thrombosis, and
enteric infarction that required resection. The newer diagnostic modalities
of computed tomography and ultrasound may document unsuspected
pylethrombosis. Surgery may be required because of signs of peritonitis,
enteric ischemia, or unresolved sepsis. Anticoagulation is indicated for
acute thrombosis of the portal or superior mesenteric veins to prevent
further extension and enteric ischemia.
