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Hepatic periportal tracking associated with severe acute pyelonephritis
1Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, Israel.
Abdominal Imaging
|May 24, 2000
Summary
Computed tomography (CT) revealed hepatic perivascular halos in three sepsis patients with acute pyelonephritis. This finding suggests pyelonephritis can cause hepatic lymphatic abnormalities, expanding the differential diagnosis for such CT appearances.
Area of Science:
- Radiology
- Nephrology
- Hepatology
Background:
- Hepatic perivascular halos on computed tomography (CT) are associated with various conditions.
- Altered hepatic lymphatic dynamics can manifest as these radiologic findings.
Observation:
- Three patients with sepsis from acute pyelonephritis presented with anasarca.
- Identical CT features included periportal edema, ascites, pleural effusion, thickened gallbladder wall, and dilated inferior vena cava.
Findings:
- The observed CT findings in these pyelonephritis cases were not linked to previously described causes of altered hepatic lymphatic dynamics.
- Acute severe pyelonephritis represents a novel etiology for hepatic perivascular lucencies.
Implications:
- Acute pyelonephritis should be considered in the differential diagnosis for patients exhibiting hepatic perivascular halos on CT.
- This expands the understanding of extrahepatic conditions affecting hepatic lymphatic circulation.
- Highlights the importance of considering renal sepsis in the evaluation of unexplained hepatic lymphatic abnormalities.