1. Image Challenge Q:
What is the most likely diagnosis associated with fever and jaundice and these image findings?
1. Pancreatitis
2. Pyelonephritis
3. Pericarditis
4. Pancreatic malignancy
5. Pylephlebitis

2. Image Challenge Q:
What is the most likely diagnosis associated with fever and jaundice and these image findings?
Answer:
Pylephlebitis
Pylephlebitis is the correct answer. It is the thrombophlebitis of the portal venous system which is associated with intraabdominal infections such as diverticulitis, appendicitis, inflammatory bowel disease, and necrotizing pancreatitis. The patient may present with nonspecific symptoms such as fever, abdominal pain, and nausea. Fat stranding around the inferior mesenteric vein is seen in this image along with peripheral perforated diverticulitis. Gas in the inferior mesenteric vein is seen leading up to the origin of the portal vein.