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Intestinal anisakiasis with small bowel obstruction following recurrent gastric anisakiasis

  • Hiroki Kojima
    Correspondence
    Corresponding author: Hiroki Kojima, MD, Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan
    Affiliations
    Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
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Published:September 22, 2022DOI:https://doi.org/10.1016/j.amjms.2022.09.013
      A 52-year-old man presented with acute upper abdominal pain after having eaten raw mackerel fish the day before. Gastric anisakiasis was suspected, and a gastric endoscopy revealed one anisakis nematode in the lower body of the greater curvature of the stomach, which was resected (Fig. 1A). The abdominal pain stopped but recurred after 3 hours. Another gastric endoscopy was performed and revealed another anisakis nematode in the stomach, which was resected. The upper abdominal pain stopped, but the next day lower abdominal pain and diarrhea subsequently occurred. He presented to the hospital again, and a physical examination revealed tenderness in the lower abdomen. A contrasted abdominal computer tomography scan revealed thickening of the gastric wall, ileum, and ascending colon and diffuse dilatation of the ileum, suggesting gastritis, enterocolitis, and small bowel obstruction (Fig. 1B). He was treated by fasting for 3 days. Symptoms gradually improved, and dilatation of the small bowel was found to have resolved via abdominal x-ray. After restarting eating, the symptoms did not recur.

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