Clin Endosc.  2013 May;46(3):293-296. 10.5946/ce.2013.46.3.293.

A Case of Anisakiasis Invading the Stomach and the Colon at the Same Time after Eating Anchovies

• Kim SH
• Park CW
• Kim SK
• Won S
• Park WK
• Kim HR
• Nam KW
• Lee GS

• KMID: 2048937
• DOI: http://doi.org/10.5946/ce.2013.46.3.293

Abstract

Anisakiasis of the gastrointestinal tract is caused by the ingestion of raw fish or uncooked food infested with Anisakis larvae. A large number of cases of gastric anisakiasis have been reported in countries where the eating of raw fish is customary. However, there have been few reports of anisakiasis of the colon confirmed by colonoscopy and also very few reports of endoscopic ultrasonographic findings of anisakiasis. A 47-year-old man had epigastric pain with nausea after eating raw anchovies. Endoscopy found a living tubular structure penetrating into the lesser curvature of the stomach and the midtranseverse colon area. It was withdrawn with biopsy forceps. We report a case of anisakiasis simultaneously invading the stomach and the colon confirmed by endosopic utrasonographic findings and biopsy findings.

Keyword

Anisakiasis; Endoscopy; Endosonography

MeSH Terms

Anisakiasis
Anisakis
Biopsy
Colon
Colonoscopy
Eating
Endoscopy
Endosonography
Gastrointestinal Tract
Larva
Nausea
Stomach
Surgical Instruments

Figure

• 

  Fig. 1 Endoscopic and endosonographic findings of the stomach. (A) An anisakid larva is penetrating into the mucosa of the lesser curvature of the gastric body. The gastric mucosa around the worm shows marked hyperemia. (B) The worm is captured by endoscopic forceps for removal. (C) On endosonography, gastric wall thickening can be seen. The most thickened layer is the submucosa (third layer of the stomach). Its character is homogenous and relatively hypodense. The 5-layered wall structure is well preserved. m, mucosal layer; sm, submucosal layer; mp, muscularis propria.

• 

  Fig. 2 Colonoscopic and endosonographic findings of the colon. (A) An anisakid larva penetrating the mucosa is seen on the transverse colon. (B) The worm is captured by endoscopic forceps for removal. (C) Endosonography shows diffuse edematous thickening of the submucosal layer. Thickened submucosal layer shows generally homogenous echo and is not easily distinguishable from the other layers. m, mucosal layer; sm, submucosal layer.

• 

  Fig. 3 Biopsy findings. (A) Stomach biopsy shows gastritis with eosinophil infiltration without eosinophilic granuloma (H&E stain, ×200). (B) Colon biopsy shows colitis with eosinophil infiltration (H&E stain, ×100).

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