Clinicopathologic Studies on Larval Anisakiasis in Japan

A Case of Anisakiasis as a Cause of Ileum Obstruction

“…However, in the United States where such dietary habits are not common, more than 50 case reports of anisakia sis have been confirmed over the past 20 years, and the number is steadily increasing [6][7][8]. Furthermore, sev eral cases have recently been reported from the United Kingdom [9] and other European countries [10]. With the increased popularity of eating raw or lightly cooked fish and squid, and with the present flux of international travel, there may be a real potential for anisakiasis in any country where fish or squid is consumed.…”

“…More than 60% of the anisakiasis cases (92 cases) in a clinicopathologic study were diagnosed preoperatively as appendicitis, gastric tumors and cancer, tu berculous peritonitis, or ileitis [10]. The accurate diagno sis is dependent on an accurate history, an appropriate degree of suspicion and a close follow-up of the patient.…”

“…The adult stage of this type of larva is Anisakis simplex [1]. In addition to the cases caused by Anisakis, larvae of the genus Terranova were recently identified as the etiologic agents in cases of acute abdominal syndrome in Japan, and a larva of Contracaecum osculatum was reported to be the causative agent of eosinophilic granuloma of the intestine in a case in West Germany [12], Larvae Terranova are generally noninvasive, cause mild or no symptoms, and rarely migrate beyond the stomach [ 1,10,13], These worms can cause the 'tingling throat' syndrome and are often expectorated days to weeks after ingestion. Larvae Anisakis, however, can be invasive, penetrating into the stomach mucosa [5,7] and migrating to extragastric sites, e.g., duodenum, ileum, jejunum, colon, peritoneum, liver, pancreas [1,4], and lung [14], If the worms are thought to be the cause of gastric distress, an endoscopic examination may be per formed and the worms removed with biopsy forceps [5], Upper gastrointestinal tract x-rays have also been helpful in identifying the presence of the worms.…”

Utilidad de la anamnesis y de las técnicas inmunológicas en el diagnóstico de la anisakidosis en pacientes con abdomen agudo

“…Este parásito tiene varias formas de presentación: gástri-ca, intestinal, extra-gastrointestinal (heteróloga o ectópi-ca), gastroalérgica y reacciones de hipersensibilidad mediadas por IgE, esta última también producida tras la ingestión de pescado adecuadamente cocinado (3)(4)(5), hecho puesto en duda por algunos autores (6). El curso clí-nico de la anisakidosis digestiva puede ser agudo y autolimitado, subagudo o crónico y, probablemente en la mayoría de los casos, oligosintomático (7,8).…”

“…El diagnóstico se confirma al observar la larva, cuando es expectorada o extraída mediante endoscopia de zonas accesibles (esófago, estómago, colon); sin embargo, es más difícil cuando la larva migra hacia el intestino delgado o es extra-gastrointestinal, requiriendo con frecuencia cirugía (2,(12)(13)(14)(15)(16)(17), o cuando la infestación se hace cró-nica y la larva es destruida por el sistema inmune (7,(18)(19)(20). El diagnóstico inmunológico se basa en la prueba cutánea con extracto crudo de larva de A. simplex y en la determinación de IgE específica frente a este (21)(22)(23)(24).…”