Hepatic larva migrans presenting with upper gastrointestinal haemorrhage: A case report

Visceral larva migrans (VLM) occurs because of a host inflammatory response to the migrating larvae of a nematode. Patients usually present with fever, hepatomegaly and abdominal pain; vascular arterial complications are uncommon. A 19-year female presented with fever, jaundice, abdominal discomfort and melena. Computed tomography (CT) revealed multiple discrete, clustered, complex hepatic cystic lesions consistent with VLM, along with an arterial pseudoaneurysm from the right hepatic artery which was managed with endovascular coil embolisation.

MDCT Angiography Evaluation of Arterial Involvement in Carcinoma Gall Bladder: An Institutional Experience

Purpose: Evaluation of pattern of arterial involvement in advance case of gallbladder carcinoma with MDCT Angiography. Method: All CT examinations were performed on a 64- MDCT scanner (Philips Medical System Version 6.4, Extended Brilliance Workspace). Technical features of MSCT were as following 64mm � 1mm collimation, minimum slice thickness of 0.625, gantry rotation time of 320ms, kV of 120, and mAs of 320. CT Angiography was performed with IV administration of nonionic contrast material i.e. omnipaque. The contrast medium and saline solution were injected with a medrad power injector at 4mL/sec through an 18-gauge plastic intravenous catheter placed in an antecubital vein in most of the cases. Contrast medium volumes varied between 100 and 150 mL at 1.5ml/Kg. Images were obtained in triphasic pattern at arterial (20-30 seconds), portal (60-70 seconds), and equilibrium (at 3 minutes) phases. Results: Nearly half of the cases (43.5%) of carcinoma gall bladder showed arterial involvement at the time of diagnosis; most commonly involved artery was found to be cholecystic artery (24.7%) followed by right hepatic artery (14.1%) and replaced right hepatic artery (3.5%). Conclusion: We conclude that nearly half of the patients with carcinoma gall bladder have arterial involvement at the time of diagnosis. The most commonly artery involved was Cholecystic artery followed by right hepatic artery and replaced right hepatic artery. Keywords: MDCT (Multidetector computed tomography); Carcinoma gall bladder; Cholecystic artery; Hepatic artery; Right hepatic artery