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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Diverticulitis complicated by pylephlebitis: a case report | Gajendran et al. Journal of Medical Case Reports 2011 5 514 http www.jmedicalcasereports.eom content 5 1 514 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Diverticulitis complicated by pylephlebitis a case report Mahesh Gajendran1 Thiruvengadam Muniraj2 and Mohamed Yassin2 Abstract Introduction Pylephlebitis is defined as septic thrombophlebitis of the portal venous system usually secondary to infection or inflammation in the abdomen. In the current report we present a case of pylephlebitis that complicated the course of a very common pathology diverticulitis. Case presentation A 62-year-old Caucasian woman with a history of sigmoid diverticulitis presented to our facility with a three-week history of abdominal pain fevers chills loss of appetite and fatigue. Her laboratory test results showed leukocytosis and elevated alkaline phosphatase. A computed tomography scan revealed portal vein thrombosis and a sigmoid diverticulitis with an abscess. Our patient was given pipercillin-tozabactam followed by sigmoid colectomy and loop transverse colostomy. A peritoneal fluid sample culture grew Escherichia coli. Our patient had an uneventful post-operative course and the leukocytosis resolved in the next four days. She improved clinically and was discharged home on ertapenem and enoxaparin. A follow-up computed tomography scan two weeks later showed a new pelvic abscess that was drained by a pigtail catheter but there was no change in the portal venous thrombus. A repeat computed tomography scan one month later revealed resolution of the pelvic abscess but persistence of portal vein thrombus for which enoxaparin was continued. Conclusions This is a classic case of pylephlebitis that demonstrates the importance of recognizing that the portal vein thrombus is infected and treating the condition appropriately. Introduction Pylephlebitis is defined as septic thrombophlebitis of the portal venous system usually secondary to infection or inflammation in the abdomen. The