TY - JOUR T1 - RAdiological case of the month AU - Giuliano CT, Zerykier A, Haller JO, Wood BP Y1 - 1989/09/01 N1 - 10.1001/archpedi.1989.02150210135033 JO - American Journal of Diseases of Children SP - 1099 EP - 1100 VL - 143 IS - 9 N2 - A 12-year-old Asian boy with a diagnosis of acute lymphocytic leukemia received induction chemotherapy with good response. One month later, during the intensification phase of his chemotherapy, he was admitted to the hospital for abdominal pain.On physical examination he appeared to be in poor physical health with generalized abdominal tenderness. Abnormal laboratory values included an erythrocyte sedimentation rate of 66 mm/h, and elevated amylase, aspartate aminotransferase, and alkaline phosphatase levels. The patient continued to reach temperatures of 39.4°C, despite antibiotic therapy with cephalothin, gentamicin sulfate, and carbenicillin disodium. His condition deteriorated, and he was taken to the operating room for exploratory laparotomy following computed tomographic (Fig 1) and gallium 67 citrate (Fig 2) studies.Denouement and Discussion  Pylephlebitis Secondary to Unsuspected Appendiceal Rupture  On exploratory laparotomy, the patient was found to have a ruptured appendix with microabscess formation in both lobes of the liver (pylephlebitis), an unusual complication of SN - 0002-922X M3 - doi: 10.1001/archpedi.1989.02150210135033 UR - http://dx.doi.org/10.1001/archpedi.1989.02150210135033 ER -