Septic thrombosis of the portal vein: CT and clinical observations

The CT and clinical findings were reviewed in seven patients with septic thrombosis of the portal vein (STPV). Of the seven patients, five had associated pyogenic liver abscesses. Five of seven patients presented de novo with STPV without a clinically obvious extrahepatic source of intraabdominal infection. All seven patients were successfully managed nonsurgically with intravenous antibiotics and in two patients percutaneous drainage of hepatic abscesses. Serial follow-up examinations in five patients demonstrated complete resolution of portal venous thrombus in three patients and progression to cavernous transformation in two. When diagnosed early by CT or sonography, STVP may have a more benign clinical course following appropriate antibiotic therapy.