E5343. In the Shadows: Abdominal Manifestations of Parasitic Disease
Authors
David Kakish;
University of California, Irvine
James Shi;
University of California, Irvine
Background
Parasites are organisms that live in and at the expense of their hosts. Many parasites progress through complex life cycles with stages in which human bodies may serve as hosts and experience parasitic diseases. In developing countries, parasites comprise a remarkable proportion of intestinal infections–with a prevalence ranging from 30–60%–and are ultimately responsible for consequential morbidity and mortality. In the United States, parasitic infections are routinely misdiagnosed and underdiagnosed despite becoming increasingly prevalent and disproportionately targeting the nation’s socioeconomically disadvantaged and immigrant communities. Although education for physicians in parasitic infections begins in medical school, radiologists scarcely encounter parasites in routine practice and, thus, postgraduate training can inadequately prepare residents and fellows to diagnose these microorganisms in clinical practice. As a result, parasitic diseases can pose a diagnostic dilemma and it is vital for interpreting physicians to be aware that gastrointestinal parasitic infections can be suspected based on imaging findings and included on a differential diagnosis. Parasitic disease is often treatable and expedient management can alleviate morbidity. This educational exhibit will review imaging manifestations of parasitic infections within abdominal imaging. The goal of this exhibit is to educate practicing radiologists, trainees, and clinicians on these less frequently encountered microorganisms to increase diagnostic confidence and facilitate subsequent management.
Educational Goals / Teaching Points
The goal of this educational exhibit is to review the presentations of parasitic infections within abdominal imaging. Each parasitic microorganism will be described based on the presenting symptoms, associated disease, relevant laboratory results, imaging findings, and management. Thus, viewers will develop an awareness of key potential imaging manifestations that aid in the diagnosis of these parasites to prompt timely identification and management of these often-treatable microorganisms.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Gastrointestinal implications of parasitic disease will be the key anatomic issues examined by this exhibit. Specifically, the pathophysiologic issues will center around potential parasitic manifestations involving the liver, biliary tract, pancreas, esophagus, stomach, and intestines. Imaging findings will be described on a variety of modalities and may include CT, MR, ultrasound, and fluoroscopy.
Conclusion
As noteworthy, yet manageable, culprits behind gastrointestinal disease, parasites are relatively understudied in medical–and particularly radiology–education. Abdominal parasitic infections are a commanding cause of morbidity and mortality worldwide, with expanding prevalence in the United States. By recognizing and addressing this dormant weakness, radiologists who suspect relevant parasitic diseases on imaging can facilitate expedient diagnosis and management.
