HISTORY AND CLINICAL FINDINGS: A 30-year-old male was transferred to the intensive care unit with worsening @entity295 of unknown origin and a known history of @entity30 . The @entity1 presented with a five-day history of @entity390 , @entity221 , and serous @entity294 . Clinical examination of the abdomen was unremarkable except for mild @entity158 on palpation. INVESTIGATIONS: Computed tomography (CT) of the abdomen revealed gas within the intrahepatic branches of the portal venous system, thickening of the wall of the neoterminal ileum, and mild @entity843 . In addition, ultrasonography showed acute @entity715 of the portal vein and the superior mesenteric vein. No wall perfusion was seen in either the neoterminal ileum or the ascending colon on color Doppler sonography. DIAGNOSIS, TREATMENT AND COURSE: Based on the combination of portal vein @entity715 along with venous gas in the portal venous system and absence of intestinal perfusion, the diagnosis of pylephlebitis with @entity326 was suspected and a laparotomy was performed. Intraoperative exploration revealed phlegmonous @entity30 , a significant amount of cloudy fluid, and @entity715 of the mesenteric vein. A right-sided hemicolectomy with ileotransversostomy was performed. Histologic examination confirmed @entity30 that was associated with @entity1333 and, in particular, with @entity2268 and subsequent transmural bowel @entity39 . Antibiotic and anticoagulation therapy was resumed without further complications. CONCLUSION: In the differential diagnosis of @entity295 , especially in combination with @entity490 or gas in the portal venous system, pylephlebitis should be taken into account. Because of the high mortality, immediate further diagnostic testing and appropriate therapy of this rare diagnosis are necessary.

[Pylephlebitis with air in the portal vein system. An unusual focus in a @entity1 with XXXX ].

@entity1 :: ('9606', 'Species') :: ['patient'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity390 :: ('MESH:D009325', 'Disease') :: ['nausea'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity1333 :: ('MESH:D014657', 'Disease') :: ['vasculitis'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity294 :: ('MESH:D003967', 'Disease') :: ['diarrhea'] @entity843 :: ('MESH:D001201', 'Disease') :: ['ascites'] @entity2268 :: ('MESH:D013924', 'Disease') :: ['thrombophlebitis'] @entity30 :: ('MESH:D003424', 'Disease') :: ['terminal ileitis', "Crohn's disease"] @entity158 :: ('MESH:D010146', 'Disease') :: ['epigastric pain'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity221 :: ('MESH:D005334', 'Disease') :: ['fever']
@entity295 :: (MESH:D018805,Disease) :: ['sepsis']
