Multiple hepatic artery pseudoaneurysms associated with visceral larva migrans: a rare cause of upper gastrointestinal bleeding in a child.
Visceral (hepatic) larva migrans is a parasitic disease which predominantly affects children. This usually presents with fever and abdominal pain with occasional respiratory symptoms. Radiologically, hepatic lesions are seen in cases of hepatic visceral larva migrans. However, the lesions causing pseudoaneurysms are uncommon. We report a 3-year-old girl who presented with prolonged fever, abdominal pain and haematemesis. Laboratory investigations demonstrated anaemia, raised eosinophil count, jaundice, elevated serum IgE levels and positive Toxocara serology. Ultrasonography revealed multiple hypoechoic lesions in the liver consistent with abscesses, while abdominal CT angiography demonstrated multiple hepatic artery pseudoaneurysms arising from branches of the hepatic artery. The patient was successfully treated with transarterial embolisation along with albendazole and corticosteroid therapy, resulting in clinical and laboratory improvement. This case highlights the significance of radiological imaging in the diagnosis of visceral larva migrans in children with emphasis on close clinicoradiological integration for accurate identification of the uncommon presentation of this disease and demonstrates the value of CT angiography in identifying life-threatening arterial involvement.