title: Septic thrombophlebitis of the portal venous system: clinical and imaging findings in thirty-three patients.
abstract: OBJECTIVE
  Our purpose was to review the clinical and imaging findings in a series of patients with septic thrombophlebitis of the portal venous system in order to define criteria that might allow more confident and timely diagnosis.
  
  
  METHODS
  This is a retrospective case series. The clinical and imaging features were analyzed in 33 subjects with septic thrombophlebitis of the portal venous system.
  
  
  RESULTS
  All 33 patients with septic thrombophlebitis of the portal venous system had pre-disposing infectious or inflammatory processes. Contrast-enhanced CT studies of patients with septic thrombophlebitis typically demonstrate an infectious gastrointestinal source (82%), thrombosis (70%), and/or gas (21%) of the portal system or its branches, and intrahepatic abnormalities such as a transient hepatic attenuation difference (THAD) (42%) or abscess (61%).
  
  
  CONCLUSIONS
  Septic thrombophlebitis of the portal system is often associated with an infectious source in the gastrointestinal tract and sepsis. Contrast-enhanced CT demonstrates an infectious gastrointestinal source, thrombosis or gas within the portal system or its branches, and intrahepatic abnormalities such as abscess in most cases. We report a THAD in several of our patients, an observation that was not made in prior reports of septic thrombophlebitis.
authors.affiliation: Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Ames
authors.forename: Michael P
authors.initials: MP
authors.lastname: Federle
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000382:microbiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000000981:diagnostic imaging*; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000382:microbiology*; D014057:Tomography, X-Ray Computed