Showing 4 Abstracts.
Introduction Hepatic visceral larva migrans (VLM) is an increasingly recognized parasitic manifestation wherein migratory nematode larvae get lodged in hepatic parenchyma leading to inflammatory granuloma or abscess formation. In this report, we describe a case of VLM presenting with upper gastrointestinal (GI) bleed secondary to a rare complication, a hepatic artery pseudoaneurysm. On literature search, only one such case is reported. Case Report A 13-year-old girl presented with abdominal pain and progressively increasing jaundice for the last 2 weeks. The patient had multiple episodes of hematemesis and melaena requiring 2 units of blood transfusion during this time. Ultrasound (USG) abdomen showed multiple ill-defined hyperechoic lesions in the right lobe of liver with presence of anechoic cystic areas within. A dual phase Computed Tomography (CT) scan of the abdomen revealed multiple confluent and discrete hypodense lesions in the right lobe of liver more apparent on portal venous phase, along with presence of a 1.5 cm pseudoaneurysm arising from posterior branch of right hepatic artery. A differential diagnosis of pyogenic liver abscesses, hepatic VLM, disseminated tuberculosis and immunodeficiency with invasive fungal infection was kept along with hepatic artery pseudoaneurysm leading to hemobilia. Lab investigations revealed peripheral eosinophilia (54%) and raised serum IgE (1600 IU/mL). Hydatid serology was negative. Based on these findings, a diagnosis of hepatic VLM was made and the patient was started on Albendazole (400 mg BD). The patient underwent Digital Subtraction Angiography and managed with successful embolization of the pseudoaneurysm using microcoils. There was significant improvement in jaundice and no recurrence of hematemesis over the next ten days along with rapid drop in peripheral eosinophilia. The patient subsequently remained asymptomatic over a follow-up period of 18 months. The inflammation caused by cytotoxic eosinophil-derived proteins associated with helminthic parasites may lead to vascular complications. Conclusion Hepatic VLM can be rarely associated with hepatic artery pseudoaneurysm presenting in the form of acute upper GI bleed in the background of progressive abdominal symptoms secondary to hepatic lesions. Prompt diagnosis and management with percutaneous angio-embolization for the aneurysm and anti-helminthic therapy for the underlying parasitic infestation is of paramount importance for a good clinical outcome. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Gupta Amit, Naranje Priyanka, Kandasamy Devasenathipathy, Jana Manisha
Keywords: Visceral larva migrans, Pseudoaneurysm, GI bleed
Teaching points: The spectrum of neck masses in neonates and infants (< 2 years) differs considerably from those in older children Understand characteristic imaging appearances, particularly recognise entities that do not require sampling for diagnosis Learn algorithmic approach to differential diagnosis based on age and lesion morphology with case based examples Table of contents: Introduction: Incidence, clinical considerations Classification: Age: Neonate Cystic Branchial cleft cyst Dermoid cyst Thyroglossal duct cyst Solid: Germ cell tumor Congenital hemangioma Neuroblastoma Mixed Primitive myxoid mesenchymal tumor (PMMT) Teratoma Age: Older infants Cystic Branchial cleft cyst Dermoid cyst Thyroglossal duct cyst Solid: Lymphoma Granulocytic sarcoma Rhabdomyosarcoma Multinodular vacuolating tumor of infancy (MNTI) Solitary fibrous tumor (SFT) Fibrous tumors: Fibrous hamartoma of infancy, infantile fibrosarcoma Vascular malformation (microcystic lymphatic, venolymphatic, arteriovenous) Infections Ludwig angina Zygomycosis Practical diagnostic algorithms based on age, location (involved neck space) and morphology Conclusion Read More
Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023
Authors: Bhalla Deeksha, Jana Manisha, Manchanda Smita, Bhalla Ashu, Naranje Priyanka
Keywords: Neck tumor, congenital, vascular malformation
Chest radiograph (CXR) is a valuable tool, especially in children owing to its low cost, availability, portability and easy disinfection along with less radiation as compared to Computed Tomography (CT). In this study, we evaluate the spectrum of CXR findings and patterns in pediatric COVID-19 patients. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Gupta Amit, Bansal Abhinav, Naranje Priyanka, Jana Manisha, Bhalla Ashu, Kabra Sushil, Kandasamy Devasenathipathy
Keywords: COVID, Radiograph
Brachial plexus is a relatively common site of pediatric nerve pathology. This study was aimed at evaluation of utility of MRI and USG in the localization of brachial plexus injury in infants Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Ramachandran Anupama, Pandey R M, Jana Manisha, Kumar Atin, Kandasamy Devasenathipathy, Naranje Priyanka, Gupta Arun, Gulati Sheffali, Chakrabarty Biswaroop, Singhal Maneesh