Portal pyaemia as a presenting feature of paediatric crohn disease.

Thromboembolic complications of inflammatory bowel diseases (IBD) are well recognised and associated with a high mortality (1). Portal vein thrombosis is a rare and serious complication especially when associated with sepsis (portal pylephlebitis). Whilst it is a wellrecognised complication of Crohn disease in adults, only in 1 case has it been reported as the presenting feature (2). In paediatric practice, there is only 1 case report of this complication in an 18-year-old patient 8 years after diagnosis. We present a 14-year-old girl who presented to our unit with sepsis, jaundice and massive weight loss. Septic thrombophlebitis of the portal vein was diagnosed by abdominal computerised tomography (CT). Further investigation demonstrated she had Crohn disease. She was successfully treated with antibiotics, anticoagulants and surgical resection of affected bowel. To our knowledge, this is the first reported child who has Crohn disease presenting with portal vein pylephlebitis.