SURGICAL DRAINAGE FOR IDIOPATHIC SUPPURATIVE PYLEPHLEBITIS

Idiopathic suppurative pylephlebitis. is quite rare and only a few cas es have been reported. Conservative systemic administration of antibio tics and urokinase is reported to be effective. In this report, surgic al drainage was performed on an 18-year-old man who complained of feve r and abdominal pain. He had no past history of abdominal inflammatory disease or abdominal surgery. Ultrasonography and computed tomography showed wide spread thrombosis of the portal vein. Laparotomy was perf ormed and the occluded superior mesenteric vein was incised. Massive p us was removed. Thereafter, a drain was placed at the opened mesenteri c vein. Drainage resulted in a dramatic decrease in fever. Postoperati ve radiographic studies of the colon, the small intestine, and other o rgans did not show any abnormalities. Emergency surgical drainage was performed successfully, instead of systemic administration of antibiot ics and urokinase. Surgical drainage may be useful for wide spread pyl ephlebitis and pylethrombosis.