Pranjal Phukan

Sonographic images of hepato-pancreatico-biliary and intestinal ascariasis: A pictorial review

Despite advancement in the diagnosis and treatment of intestinal helminthiasis, ascariasis remains the most common cause of helminthic infections in the developing countries. Ultrasound offers a rapid, safe, and noninvasive approach to the diagnosis of intestinal ascariasis. Ultrasound is also the modality of choice for diagnosis of hepatobiliary ascariasis, which is relatively rare and is due to migration of intestinal worms through the papilla of Vater. We present an imaging spectrum of hepato-pancreatico-biliary and intestinal ascariasis.Main messages• Ascariasis refer to infestation by the round worm ascaris lumbricoides.• Ascaris eggs are excreted in faeces and are infective to humans.• Eggs hatch to larva, travel to the lungs and mature to adult worms.• Intestinal obstruction can be caused by multiple ascariasis forming bag of worms.

Diagnostic dilemma in a case of temporal bone carcinoma in a young man

Malignancy of temporal bone is a rare entity with an incidence of <0.2% of all head-and-neck cancer with an average age of occurrence at 60 years. We present here a case of a 21-year-old boy with temporal bone cancer who presented with clinical features of complicated chronic suppurative otitis media, radiologically as chronic osteomyelitis creating a diagnostic dilemma as there was no predisposing factor for osteomyelitis. The diagnosis was confirmed by open biopsy which revealed squamous cell carcinoma. The best survival rate is obtained with total temporal bone resection and post-operative radiotherapy.

Transnasal tracheobronchial stenting for malignant airway narrowing under local anesthesia: Our experience of treating three cases using this technique

Purpose: To study the technical feasibility of tracheobronchial stenting via transnasal route under bronchoscopy and fluoroscopic guidance in severe malignant airway strictures using self-expandable nitinol stents. Materials and Methods: We describe three patients with malignant airway strictures, treated entirely via transnasal route under local anesthesia using bronchoscopic and fluoroscopic guidance. Nasal route allowed convenient access to the airway for the bronchoscope across the stricture and a guidewire was introduced through its working channel. The 18F tracheal stent and the 6F bronchial stent assembly could be easily introduced and deployed under bronchoscopic (reintroduced through the other nostril) and fluoroscopic guidance. Results: We achieved technical success in all the three patients with immediate relief of dyspnea. Conclusion: Transnasal airway stenting with self-expandable nitinol stent using bronchoscopic and fluoroscopic guidance under local anesthesia is a safe and effective method with minimal patient discomfort.

Abdominal histoplasmosis mimicking tuberculosis in an immunocompromised patient

Histoplasmosis should be considered as a differential diagnosis especially in immune-compromised patients presenting with gastrointestinal symptoms even in areas where histoplasmosis is non endemic. The presenting symptoms often mimic abdominal tuberculosis. There are reports of simultaneous infections of both histoplasmosis and tuberculosis in patients with acquired immunodeficiency syndrome (AIDS). With early diagnosis and aggressive antifungal therapy gastrointestinal histoplasmosis has a very good prognosis. Here we are reporting a case that initially presented with clinical and radiological evidence initially suggestive of abdominal tuberculosis which on further work up was diagnosed as abdominal histoplasmosis.