Cholestatic jaundice revealing pylephlebitis associated with mesenteric venous thrombosis

Authors

DOI:

https://doi.org/10.47892/rgp.2026.461.2142

Keywords:

Venous Thrombosis, Jaundice, Anticoagulants, Thrombectomy

Abstract

Mesenteric venous thrombosis is an uncommon but highly morbid condition with nonspecific clinical manifestations that may delay early diagnosis. We report the case of a 65-year-old man with a history of venous insufficiency and chronic smoking, who presented with abdominal pain, jaundice, and fever. Imaging revealed extensive thrombosis of the superior mesenteric vein, pylephlebitis, and heterozygous C677T MTHFR mutation. The patient was treated with antibiotics, anticoagulation, and transhepatic portal thrombectomy minimally invasive with thrombolysis, showing favorable clinical and biochemical recovery. This case highlights the importance of considering both infectious and prothrombotic conditions in patients with abdominal pain and jaundice, emphasizing the role of a multidisciplinary approach.

Downloads

Download data is not yet available.

References

Demelo-Rodríguez P, Ordieres-Ortega L, Oblitas CM. Mesenteric venous thrombosis. Med Clin (Barc). 2023;160(9):400-6. doi: 10.1016/j.medcli.2023.01.020.

Russell CE, Wadhera RK, Piazza G. Mesenteric venous thrombosis. Circulation. 2015;131(18):1599-603. doi: 10.1161/ CIRCULATIONAHA.114.012871.

Blumberg SN, Maldonado TS. Mesenteric venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2016;4(4):501-7. doi: 10.1016/j.jvsv.2016.04.002.

Tan R, Daneshmand A, Parys S, Watanabe Y, Sieunarine K. Splanchnic venous thrombosis: Aetiologies and review of the literature. ANZ J Surg. 2022;92(9):2224-2228. doi: 10.1111/ ans.17863.

Kanellopoulou T, Alexopoulou A, Theodossiades G, Koskinas J, Archimandritis AJ. Pylephlebitis: an overview of non-cirrhotic cases and factors related to outcome. Scand J Infect Dis. 2010;42(11-12):804-11. doi: 10.3109/00365548.2010.508464.

Singal AK, Kamath PS, Tefferi A. Mesenteric venous thrombosis. Mayo Clin Proc. 2013;88(3):285-94. doi: 10.1016/j. mayocp.2013.01.012.

Ozdil B, Kece C, Cosar A, Akkiz H, Sandikci M. Septic thrombophlebitis of the portal vein (pylephlebitis). Turk J Gastroenterol. 2007;18:117-119. doi: 10.1093/clinids/21.5.1114.

Baril N, Wren S, Radin R, Ralls P, Stain S. The role of anticoagulation in pylephlebitis. Am J Surg. 1996;172(5):449- 52. doi: 10.1016/S0002-9610(96)00220-6.

Hmoud B, Singal AK, Kamath PS. Mesenteric venous thrombosis. J Clin Exp Hepatol. 2014;4(3):257-63. doi: 10.1016/j.jceh.2014.03.052.

Bezemer ID, Doggen CJM, Vos HL, Rosendaal FR. No association between the common MTHFR 677C->T polymorphism and venous thrombosis: results from the MEGA study. Arch Intern Med. 2007;167(5):497-501. doi: 10.1001/archinte.167.5.497.

Aksu K, Donmez A, Keser G. Inflammation-induced thrombosis: mechanisms, disease associations and management. Curr Pharm Des. 2012;18(11):1478-93. doi: 10.2174/138161212799504731.

Choudhry AJ, Baghdadi YM, Amr MA, Alzghari MJ, Jenkins DH, Zielinski MD. Pylephlebitis: A Review of 95 cases. J Gastrointest Surg. 2016;20(3):656-61. doi: 10.1007/s11605- 015-2875-3.

Plemmons RM, Dooley DP, Longfield RN. Septic thrombophlebitis of the portal vein (pylephlebitis): Diagnosis and management in the modern era. Clin Infect Dis. 1995;21(5):1114-20. doi: 10.1093/clinids/21.5.1114.

Published

03/29/2026

How to Cite

1.
Chávez-Sánchez SA, Escobar-Montes RH, Bellido-Caparó Álvaro, Mejía-Cordero FA, Del Villar-Alarcón CA, Chávez-Peche JA. Cholestatic jaundice revealing pylephlebitis associated with mesenteric venous thrombosis. Rev Gastroenterol Peru [nternet]. 2026 Mar. 29 [cited 2026 Mar. 30];46(1):88-91. vailable from: https://revistagastroperu.com/index.php/rgp/article/view/2142

Issue

Section

REPORTES DE CASOS

Most read articles by the same author(s)

1 2 > >>