Pylephlebitis and pyogenic liver abscesses: a complication of hemorrhoidal banding

Abstract

Hemorrhoidal banding is a well-established and safe outpatient procedure. Septic complications of hemorrhoidal banding are rare but can be fatal. The first case of pylephlebitis (septic portal vein thrombosis) and pyogenic liver abscess following hemorrhoidal banding in a 49-year-old man with diabetes is reported in the present study. Risk factors, management and the role of prophylaxis in immunocompromised patients are discussed. Caution against hemorrhoidal banding in immunosuppressed patients, including patients with diabetes, is warranted.

Figures

Figure 1)

Computed tomography scan of the abdomen showing right, left and main portal vein thrombosis, splenic and superior mesenteric vein thrombosis and small, hypodense liver lesions consistent with multifocal abscesses. Arrow indicates a lobulated hepatic abscess above the hilum