Pylephlebitis With Reversible Mesenteric Ischemia in a Patient With Complicated Acute Appendicitis: A Case Report

Pylephlebitis is a rare complication of intra-abdominal and pelvic infections, occurring in the context of conditions such as acute appendicitis and diverticulitis, among others. It consists of septic thrombophlebitis of the portal vein and/or its tributary branches. Early diagnosis of this condition is crucial to prevent serious complications like sepsis and mesenteric ischemia. Contrast-enhanced abdominal CT scan is the test of choice for diagnosis and for evaluating potential complications, and the correct interpretation of radiological findings is essential to avoid unnecessary interventions. This case report describes an adult patient with pylephlebitis secondary to acute appendicitis and a rare association with mesenteric-colonic ischemia. The patient had a favorable outcome following treatment with antibiotics and anticoagulants, and the ischemia was reversible. The report emphasizes the radiological findings.