A 46-year-old man with end-stage liver disease secondary to hepatitis C with diarrhea, fever, and worsening liver failure.
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Biomedical subjects
Publications and source records attributed to Ashish Chawla.
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Ascaris lumbricoides is the most common helminth affecting humans. Ascariasis can result in serious complications, including intestinal obstruction and perforation. Early diagnosis and treatment of such complications reduces the risk of mortality. We present a case of sonographically diagnosed ascaridial perforation in a 5-year-old girl. On sonography, each ascarid appeared as 2 pairs of parallel lines, representing the worm's outer margins, flanking a central sonolucent line, representing its digestive tract. Sonography revealed ascarides in the peritoneal cavity and in some loops of the small bowel. Emergent laparotomy was performed to remove ascarides from the peritoneal cavity and terminal ileum, and the patient recovered well and was asymptomatic at a 3-month follow-up. Knowledge of the sonographic features described herein may aid in the evaluation of patients, especially children, in tropical countries who have clinical symptoms of ascariasis.
Kernicterus (bilirubin encephalopathy) is a disease entity with a very high rate of mortality in neonates. The children who survive are left with neurological deficits such as choreoathetosis, sensorineural deafness and mental retardation. Magnetic resonance imaging of the brain in this condition has specific findings which aid in the accurate diagnosis of the condition, along with clinical and biochemical criteria. Reports have shown involvement of the globus pallidus, putamen, and less commonly the thalamus. More specific involvement may be isolated lesions of the globus pallidus. Magnetic resonance imaging has shown a good sensitivity in this condition.
This article discusses patients with inflammatory bowel disease (IBD), a group which is at increased risk for colorectal carcinoma based on extent and duration of their disease. Patients with chronic IBD (at least 8-10 years duration) should be screened with colonoscopy every 1 to 2 years with multiple jumbo biopsies every 10 cm through the entire colon. Patients with sporadic adenomas can be followed after complete polypectomy, whereas patients with adenoma-like dysplasia-associated lesion or mass (DALMs) need increased surveillance. Patients with flat dysplasia or non adenoma-like DALMs are at high risk for progression and should undergo colectomy. The patients who have indeterminate lesions can be differentiated based on the endoscopic, histologic, and molecular features of the lesion. Long-term follow-up is necessary to determine the natural history of these lesions.