Imaging hepatobiliary manifestations of parasitosis – hints leading to the differential diagnosis

Congress:

ECR 2019

Poster Number:

C-2655

Type:

Educational Exhibit

Keywords:

Liver, Ultrasound, CT, MR, Imaging sequences, Complications, Parasites, Abscess, Cysts

Authors:

L. B. Castelo David¹, W. Schmitt², P. Joao³, A. M. D. Costa⁴, A. S. C. C. Germano⁵; ¹Amadora-Lisbon/PT, ²Amadora, Porto/PT, ³Lisboa/PT, ⁴Amadora/PT, ⁵Barcarena /PT

DOI:

10.26044/ecr2019/C-2655

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2655

Fig. 1: Entamoeba hystolitica: Transmission route and life-cycle.

Fig. 2: 37 year-old male patient Presented to the ER complaints of asthenia, anorexia,...

Fig. 3: 37 year-old male patient Presented to the ER complaints of asthenia, anorexia,...

Fig. 4: 37 year-old male patient Presented to the ER complaints of asthenia, anorexia,...

Learning objectives

To summon up the parasites’ transmission routes and life-cycles. To review US, CT and MRI signs pertaining to hepatobiliary expressions of parasitary (protozoa and helminths) diseases. To provide clues to achieve the differential diagnosis, namely with other inflammatory/infectious conditions and with primary or secondary tumours.

Background

Gastrointestinal parasites’ involvement in the hepatobiliary system is a rare occurrence. The diagnosis is sometimes straightforward, but can prove challenging in many cases, as both clinical symptoms and imaging are often nonspecific. Suspicion can be raised by the patients’ past history and geographical area of residence or travel, and later confirmed by laboratory tests and imaging follow-up after treatment.

Findings and procedure details

We retrospectively selected and analysed relevant radiological findings of X-ray, Ultrasound, CT, and MRI images from our Institutions’ databases. Hepatobiliary typical and atypical spectrum of manifestations of Entamoeba hystolitica, Schistosomiasis, Echinococcus, Fasciola, and Ascaris lumbricoides will be highlighted. Parasites are endemic in some regions, but are spreading worldwide due to travel. Involvement of the hepatobiliary system is infrequent. The diagnosis is challenging because most patients are asymptomatic in the initial phases. Suspicion is raised by considering epidemiologic data. Imaging examinations are often the key to...

Conclusion

Radiology plays an important role in the early detection, characterisation, and management of infectious hepatobiliary disease. An early diagnosis and management allows a prompt and targeted treatment and, as a result, the cure of the condition itself.

Personal information

References

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