Solution: This patient has multiple findings. First, there is a focal perforation of the sigmoid colon with associated pericolonic abscess in the left lower quadrant. Second, there is thrombosis of the portal vein and mesenteric vins and third, there are numerous intrahepatic abscesses. The differential could include a colonic mucinous carcinoma with associated liver metastases, but that wouldn't really explain the thrombosis of the portal vein and a primary hepatic malignancy with tumor thrombosis wouldn't explain the colon findings. The hepatic abscesses have a fairly characteristic appearance. Treatment is antibiotics, anticoagulation with percutaneous drainage and possible surgery for drainage of the pericolonic abscess and associated colon resection.