Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report

Abstract

We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient’s history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.

Anisakiasis of the Terminal Ileum Removed by Colonoscopy

“…Conservative treatment is generally effective, although patients are admitted for an average of 9 days and about 7% require surgery [ 7 , 11 ]. Cases of successful treatment using Gastrografin or steroids with antihistamines have been reported [ 18 , 19 ]. However, endoscopic removal is the only available method of removing the causative parasite without surgery.…”

Gastric Anisakiasis Masquerading as Gastroesophageal Reflux Disease

“…In humans, Anisakis have been found in the mucosa of the stomach and intestine and less commonly in the omentum, liver, pancreas, and lung [3][4][5]. Clinical manifestations of enteric anisakiasis include colicky abdominal pain, nausea, and vomiting [6]. Enteric anisakiasis should be suspected in patients with gastrointestinal symptoms after ingesting raw fsh; a defnite diagnosis is made by endoscopic examination [6].…”

“…Clinical manifestations of enteric anisakiasis include colicky abdominal pain, nausea, and vomiting [ 6 ]. Enteric anisakiasis should be suspected in patients with gastrointestinal symptoms after ingesting raw fish; a definite diagnosis is made by endoscopic examination [ 6 ]. Enteric anisakiasis is usually managed conservatively with analgesic drugs because the larvae die within one week in the human body [ 6 ].…”

“…Enteric anisakiasis should be suspected in patients with gastrointestinal symptoms after ingesting raw fish; a definite diagnosis is made by endoscopic examination [ 6 ]. Enteric anisakiasis is usually managed conservatively with analgesic drugs because the larvae die within one week in the human body [ 6 ]. Endoscopic removal of larvae from the stomach can hasten relief of symptoms [ 6 ].…”

“…Enteric anisakiasis is usually managed conservatively with analgesic drugs because the larvae die within one week in the human body [ 6 ]. Endoscopic removal of larvae from the stomach can hasten relief of symptoms [ 6 ]. We report a rare case of gastric anisakiasis in a patient who presented with gastroesophageal reflux disease (GERD) symptoms.…”