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A 47-year-old male suffered from high fever, abdominal pain and vomiting of 4 days of evolution. Blood tests showed high inflammatory parameters and abdominal CT revealed intrahepatic portal gas, partial thrombosis of intrahepatic left portal vein and sigmoid thickening with a possible foreign body. Broad spectrum antibiotic and anticoagulation were initiated, and control CT showed resolution of the intrahepatic pneumatosis, with no other changes. Treatment was maintained with a suspected diagnosis of a pylephlebitis secondary to an intraabdominal infection with good evolution.