Septic thrombophlebitis of the superior mesenteric vein and multiple liver abscesses in a patient with Crohn's disease at onset.
BACKGROUND
Portal-mesenteric vein thrombosis, pylephlebitis and liver abscesses are rare complications of inflammatory bowel disease (IBD). The purpose of this case report is to relate an unusual presentation of CD in order to show how conservative treatment could be an appropriate option as a bridge to the surgery, in patients with septic thrombophlebitis and multiple liver abscesses with CD.


METHODS
We report a case of a 25-year-old man with Crohn's disease (CD) who developed a superior mesenteric venous thrombosis, multiple liver abscesses and pylephlebitis, diagnosed through abdominal ultrasound and an abdominal computed tomography (CT) scan. The patient was successfully treated with conservative treatment consisting of intravenous antibiotics, subcutaneous anticoagulation and percutaneous catheter drainage of liver abscesses.


CONCLUSIONS
We reported an unnusual case of pylephlebitis in CD. Until now this association has not been reported in adult patients at onset. We hypothesise that the infection developed as a result of mucosal disease and predisposed by corticoid therapy. Adequated management was discussed.
Aguas
Mariam
M
Gastroenterology Department, Hospital La Fe, Avenida Campanar, Valencia, Spain. aguas_mar@gva.es
Bastida
Guillermo
G
Nos
Pilar
P
Beltrán
Belen
B
Grueso
Jose Luis
JL
Grueso
Julio
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004322:Drainage / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008100:Liver Abscess / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D008642:Mesenteric Veins; D013924:Thrombophlebitis / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000925:Anticoagulants