Fig. 11
From: Parasitic diseases as a cause of acute abdominal pain: imaging findings
A 21-year-old woman was admitted to the emergency department with a 1-week history of vomiting and abdominal pain. Physical examination was unremarkable except for mild epigastric tenderness. Increased serum levels of acute-phase reactants and eosinophilia were evident at blood analysis. a Axial gray-scale US image demonstrates a tubular structure (arrow) within the lumen of the stomach (asterisk). b Axial contrast-enhanced CT scan more clearly depicts the worm (arrows). c Follow-up CT scan was obtained on the 3rd day of admission due to clinical suspicion of acute pancreatitis. Mild fat stranding (arrow) and fluid (asterisk) with jejunal wall thickening (arrowheads) were noted on CT. d, e Follow-up CT scans obtained on the 5th day of admission demonstrate the evolution of peripancreatic inflammatory changes into a heterogeneous fluid collection (asterisk, d). Peripherally located liver lesions (arrows, d, e) were also noted. Imaging findings raised suspicion for the involvement of visceral larva migrans. The definitive diagnosis was achieved with the identification of Ascaris eggs in the stool examination