title: [Pylephlebitis with an uncommon aetiology].
abstract: BACKGROUND
  Pylephlebitis is a septic thrombophlebitis of the portal vein due to an intra-abdominal infection in the drainage area of this vein.
  
  
  METHODS
  We describe the case of a 77-year-old woman who presented at the emergency department with fever, cold chills and a two-month history of right upper quadrant abdominal pain. She was diagnosed with pylephlebitis without a clear infection site. Treatment consisted of antibiotics and anticoagulation. Two months after discharge she was again referred to the emergency department, this time with rectal blood loss. On endoscopy a cocktail stick was seen to be stuck in a diverticulum, 14 cm from the anus. The cocktail stick was endoscopically removed. In hindsight, the cocktail stick had been visible in the proximal colon on a previous abdominal CT scan. The pylephlebitis was probably due to a covered perforation of the caecum caused by the ingested cocktail stick which had then migrated to the distal colon.
  
  
  CONCLUSIONS
  This case illustrates the importance of discovering the aetiology of pylephlebitis to avoid possible complications.
authors.affiliation: Westfriesgasthuis, Hoorn.
authors.forename: Josine
authors.initials: J
authors.lastname: Eising
authors.forename: Matthijs R
authors.initials: MR
authors.lastname: Douma
authors.forename: Wim G
authors.initials: WG
authors.lastname: Meijer
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005547:Foreign Bodies / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D010689:Phlebitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011169:Portal Vein
chemical_list: D000900:Anti-Bacterial Agents