A case of long-term follow-up of pylephlebitis with multiple liver abscesses

Ogasawara Fumiya, Munekage Kensuke, Ono Masafumi, Ochi Tsunehiro, Ogasawara Mitsunari, Oe Keisuke, Hirose Akira, Nozaki Yasuko, Kohsaki Takuhiro, Iwasaki Shinji, Saibara Toshiji

doi:10.2957/kanzo.58.123

<p>A 50-year-old man with pyrexia and epigastralgia presented to our hospital for treatment. An increased white blood cell count (neutrophil-dominant), C-reactive protein concentration, and pro-calcitonin concentration were observed upon blood testing. Pylephlebitis was suspected because of the presence of multiple liver abscesses and portal thrombosis. Although aspiration of blood from the portal vein was performed and an abscess was observed, no bacteria were demonstrated in the blood culture. The portal vein blood flow did not resume even after improvement of the liver abscesses by treatment with antibiotics. The patient was transferred to his former hospital after improvement of the inflammation and infection despite the fact that the portal vein flow was still not improved. An abdominal computed tomography (CT) scan 2 years after discharge showed that the right portal vein flow was not detected and the right lobe of the liver was remarkably atrophied. Furthermore, liver atrophy and blood flow did not also remarkably change on CT scan 4 years after discharge. This is a rare case involving long-term follow-up after improvement of pylephlebitis. Although there are no symptoms or recurrence of the disease, long term follow up would be important because the remarkable liver atrophy could occur when portal vein flow was not resumed.</p>

A case of long-term follow-up of pylephlebitis with multiple liver abscesses

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