• Case 158: Pylephlebitis

    Radiology: Volume 255: Number 3-June 2010

    Case 158: Pylephlebitis


    Roberto García Figueiras, MD Mercedes Liñares Paz, MD Sandra Baleato González, MD Carmen Villalba Martín, MD

    A 51-year-old man presented with abdominal pain, fever, and diarrhea. He was suspected of having enteric infec­tion, and he received oral antibiotics and rehydration therapy. Despite these regular measures, his clinical status did not improve.


    Fifteen days later, the patient was admitted because of persistent fever (38.9°C), vomiting, and abdominal dis­comfort. At physical examination, his abdomen was soft and tender. Laboratory studies revealed mild anemia, with a hemoglobin level of 12.1 g/dL (121 g/L) (normal range, 12.2-17.5 g/dL [122-175 g/L]), leukocytosis with a white cell count of 16.1 X 103/µL (1.61 X 109/L) (nor­mal range, 4.0-10.0 X 103/µL [0.4-1.0 X 109/µL]), and high platelet count of 489 X 109/L (normal range, 135-381 X 109/L). Liver enzyme levels were elevated, with an alanine aminotransferase level of 68 U/L (1.14 µkat/L) (normal range, 0-29 U/L [0-0.484 µkat/L]), aspartate aminotransferase level of 539 U/L (8.985 µkat/L) (normal range, 10-37 U/L [0.167-0.617 µkat/L]), and alkaline phosphatase level of 613 U/L (10.23 µkat/L) (normal range, 65-195 U/L [1.09-3.256 µkat/L]). Bilirubin level was normal. Coagulation test results were normal.