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

Affiliations
  • 1Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea. 115203@naver.com

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 It was withdrawn with biopsy forceps.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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Reference

1. Moreno-Ancillo A, Caballero MT, Cabañas R, et al. Allergic reactions to anisakis simplex parasitizing seafood. Ann Allergy Asthma Immunol. 1997; 79:246–250. PMID: 9305232.
Article
2. Sakanari JA, McKerrow JH. Anisakiasis. Clin Microbiol Rev. 1989; 2:278–284. PMID: 2670191.
Article
3. Kobayashi A, Tsuji M, Wilbur DL. Probable pulmonary anisakiasis accompanying pleural effusion. Am J Trop Med Hyg. 1985; 34:310–313. PMID: 3920926.
4. Rushovich AM, Randall EL, Caprini JA, Westenfelder GO. Omental anisakiasis: a rare mimic of acute appendicitis. Am J Clin Pathol. 1983; 80:517–520. PMID: 6624718.
Article
5. Yokogawa M, Yoshimura H. Clinicopathologic studies on larval anisakiasis in Japan. Am J Trop Med Hyg. 1967; 16:723–728. PMID: 6066221.
Article
6. Sugimachi K, Inokuchi K, Ooiwa T, Fujino T, Ishii Y. Acute gastric anisakiasis. Analysis of 178 cases. JAMA. 1985; 253:1012–1013. PMID: 4038525.
Article
7. Alonso-Gómez A, Moreno-Ancillo A, López-Serrano MC, et al. Anisakis simplex only provokes allergic symptoms when the worm parasitises the gastrointestinal tract. Parasitol Res. 2004; 93:378–384. PMID: 15221464.
Article
8. Kim SG, Jo YJ, Park YS, et al. Four cases of gastric submucosal mass suspected as anisakiasis. Korean J Parasitol. 2006; 44:81–86. PMID: 16514287.
Article
9. Yazaki Y, Namiki M. Biopsy of gastric anisakiasis with acute symptoms. In : Ishikawa H, Namiki M, editors. Gastric Anisakiasis in Japan. 1st ed. Tokyo: Springer-Verlag;1988. p. 113–116.
10. Fujisawa K, Matsumoto T, Yoshimura R, Ayabe S, Tominaga M. Endoscopic finding of a large vanishing tumor. Endoscopy. 2001; 33:820. PMID: 11558039.
Article
11. Muraoka A, Suehiro I, Fujii M, et al. Acute gastric anisakiasis: 28 cases during the last 10 years. Dig Dis Sci. 1996; 41:2362–2365. PMID: 9011443.
12. Sakai K, Ohtani A, Muta H, et al. Endoscopic ultrasonography findings in acute gastric anisakiasis. Am J Gastroenterol. 1992; 87:1618–1623. PMID: 1442686.
13. Okai T, Mouri I, Yamaguchi Y, Ohta H, Motoo Y, Sawabu N. Acute gastric anisakiasis: observations with endoscopic ultrasonography. Gastrointest Endosc. 1993; 39:450–452. PMID: 8514085.
Article
14. Minamoto T, Sawaguchi K, Ogino T, Mai M. Anisakiasis of the colon: report of two cases with emphasis on the diagnostic and therapeutic value of colonoscopy. Endoscopy. 1991; 23:50–52. PMID: 2009841.
Article
15. Wittner M, Turner JW, Jacquette G, Ash LR, Salgo MP, Tanowitz HB. Eustrongylidiasis: a parasitic infection acquired by eating sushi. N Engl J Med. 1989; 320:1124–1126. PMID: 2710174.
16. Pacios E, Arias-Diaz J, Zuloaga J, Gonzalez-Armengol J, Villarroel P, Balibrea JL. Albendazole for the treatment of anisakiasis ileus. Clin Infect Dis. 2005; 41:1825–1826. PMID: 16288416.
Article
17. Moore DA, Girdwood RW, Chiodini PL. Treatment of anisakiasis with albendazole. Lancet. 2002; 360:54. PMID: 12114042.
Article
18. Bier JW, Deardoff TL, Jackson GJ, Raybourne RB. Human anisakiasis. Baillieres Clin Trop Med Commun Dis. 1987; 2:723–733.
19. Fontaine RE. Anisakiasis from the American perspective. JAMA. 1985; 253:1024–1025. PMID: 4038526.
Article
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