Crohn's disease presenting as septic thrombophlebitis of the portal vein (Pylephlebitis): Case report and review of the literature

Septic thrombophlebitis of the portal vein, or pylephlebitis, is an extremely rare complication of intraabdominal infection, most commonly caused by diverticulitis (1). The following case report describes a patient without previous significant medical history presenting with painless jaundice and presumed malignancy. Workup revealed pylephlebitis due to an ileal abscess secondary to Crohn's disease. The patient was successfully treated with broad spectrum antibiotics and terminal small bowel and right colon resection. To our knowledge, this is the first reported case of Crohn's disease diagnosed after presentation with pylephlebitis. (Am J Gastroenterol 1999;94:847-849. (C) 1999 by Am. Coll. of Gastroenterology).