Abdominal pain secondary to pylephlebitis: An uncommon disease of the portal venous system, treated with local thrombolytic therapy

Pylephlebitis is a rare complication of intraabdominal inflammatory processes that carries an elevated mortality rate. Even in the modern era, diagnosis and treatment are difficult because of the nonspecific nature of clinical signs and symptoms and laboratory studies. We present a patient with pylephlebitis who had rapid resolution of symptoms after administration alteplase (tPA). The outcome of this uncommon entity can be improved with a high index of clinical suspicion, better imaging modalities, and interventional radiology techniques.