Small bowel ascariasis

Case contributed by Matt A. Morgan
Diagnosis almost certain

Presentation

Weight loss and diarrhea

Patient Data

Age: 40 years
Gender: Male
Fluoroscopy
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Info

On these spot images from a small bowel follow through, there is a curvilinear filling defect in the mid ileum that remains in the same position over time. There is a thin barium column down the middle of this filling defect.

Annotated image
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Yellow arrow and ovals indicate the filling defect with a central thin barium column.

Thanks to Amr El Jack, MD for this case.

Case Discussion

Small bowel ascariasis is uncommonly seen, but it is useful to recognize its characteristic appearance. The parasite itself causes a thin curvilinear filling defect and is fixed where it is attached to the bowel. As the parasite ingests the barium from the study, one begins to see a barium study of the parasite's gastrointestinal tract... a thin barium column that parallels the lucent filling defect. 

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