# An Unusual Case of Pylephlebitis With the Involvement of Portal and Superior Mesenteric Veins

## TL;DR

This case report describes a rare instance of pylephlebitis affecting multiple veins in a patient who improved with antibiotics and anticoagulants.

## Contribution

The novelty lies in the unusual involvement of both portal and superior mesenteric veins in a single case of pylephlebitis.

## Key findings

- The patient exhibited fever, vomiting, and diarrhea, typical nonspecific symptoms of pylephlebitis.
- Contrast-enhanced computed tomography confirmed the involvement of the right and left portal veins and the superior mesenteric vein.
- Treatment with broad-spectrum antibiotics and anticoagulants led to clinical improvement.

## Abstract

Pylephlebitis is a low-incidence condition worldwide, more commonly affecting the adult population. Its clinical presentation is nonspecific, thus requiring a detailed clinical history and confirmation through imaging studies (contrast-enhanced computed tomography). The literature recommends antibiotic treatment for at least six weeks and the use of anticoagulants. When diagnosed and treated early, the prognosis is generally favorable. This report presents a case of pylephlebitis with clinical symptoms of fever, vomiting, and diarrhea. The patient was diagnosed with pylephlebitis involving the right and left portal veins and the superior mesenteric vein. She showed clinical improvement following treatment with broad-spectrum antibiotics and anticoagulants.