Published in:
01-07-2011 | Original Article
Septic Thrombophlebitis of the Portal Venous System: Clinical and Imaging Findings in Thirty-Three Patients
Published in: Digestive Diseases and Sciences | Issue 7/2011
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Aim
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.
Materials and 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.