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Aprile F, Vangeli M, Allocca M, Zilli A, Argollo MC, D’amico F, Parigi TL, Danese S, Furfaro F. Gastrointestinal Ultrasound in Infectious Diseases: A Comprehensive Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1402. [PMID: 39336443 PMCID: PMC11434242 DOI: 10.3390/medicina60091402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/16/2024] [Accepted: 08/23/2024] [Indexed: 09/30/2024]
Abstract
Infectious diseases affecting the gastrointestinal tract often present diagnostic challenges due to the variability in clinical manifestations and overlapping symptoms. Ultrasound imaging has emerged as a valuable tool in the assessment of gastrointestinal pathologies, offering non-invasive and real-time visualization of anatomical structures. This review aims to explore the role of ultrasound in the diagnosis and management of infectious diseases involving the gastrointestinal tract. We discuss the imaging features of various infectious etiologies, such as bacterial, viral, and parasitic infections, highlighting characteristic findings on ultrasound scans. Additionally, we provide insights into the utility of ultrasound for the assessment of treatment response. Through a comprehensive analysis of existing literature and clinical case studies, this review underscores the significance of ultrasound imaging as a frontline modality in the diagnosis and management of infectious diseases affecting the gastrointestinal tract.
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Affiliation(s)
- Francesca Aprile
- Department of Hepatology and Gastroenterology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy; (F.A.); (M.V.)
| | - Marcello Vangeli
- Department of Hepatology and Gastroenterology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Italy; (F.A.); (M.V.)
| | - Mariangela Allocca
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
| | - Alessandra Zilli
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
| | - Marjorie Costa Argollo
- Gastroenterology Department, Federal University of São Paulo, São Paulo 04021-001, Brazil;
| | - Ferdinando D’amico
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
| | - Tommaso Lorenzo Parigi
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Silvio Danese
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
- Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Federica Furfaro
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy; (M.A.); (A.Z.); (T.L.P.); (S.D.); (F.F.)
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Fornell Pérez R, Urizar Gorosarri M, Pérez Bea M. Anisakiasis: Imaging findings. RADIOLOGIA 2022; 64:245-255. [PMID: 35676056 DOI: 10.1016/j.rxeng.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To review the main findings for anisakiasis in the different imaging tests that can be used to diagnose it, based on studies done at our center. CONCLUSION The presence of Anisakis species in food consumed in Western countries is becoming more common. Patients with anisakiasis present with acute abdomen; there are no specific clinical signs or laboratory findings. Careful history taking is key to discovering exposure to Anisakis-contaminated food, but this task is hindered by unfamiliarity with the condition and lack of suspicion and is also confounded by the variable latency period after ingestion of Anisakis-contaminated food. Give the nonspecific presentation, patients with anisakiasis often undergo imaging tests to rule out other processes. Thus, radiologists need to be familiar with the spectrum of imaging findings that should lead to the inclusion of anisakiasis in the differential diagnosis, so they can guide clinicians toward directed history taking and specific tests.
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Affiliation(s)
- R Fornell Pérez
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, Spain.
| | - M Urizar Gorosarri
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, Spain
| | - M Pérez Bea
- Servicio de Radiodiagnóstico, Hospital Universitario Basurto, Bilbao, Bizkaia, Spain
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Fornell Pérez R, Urizar Gorosarri M, Pérez Bea M. Anisakiasis: manifestaciones radiológicas. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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González-Bertolín B, Hernanz-Ruiz N, Pérez-Tanoira R, Perteguer-Prieto MJ. Colonic anisakiasis, an infrequent case molecularly characterized by PCR-RFLP. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2021; 39:308-309. [PMID: 34088457 DOI: 10.1016/j.eimce.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/05/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Belén González-Bertolín
- Laboratorio de Helmintos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
| | - Nerea Hernanz-Ruiz
- Servicio de Aparato Digestivo, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Ramón Pérez-Tanoira
- Servicio de Microbiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - María Jesús Perteguer-Prieto
- Laboratorio de Helmintos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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González-Bertolín B, Hernanz-Ruiz N, Pérez-Tanoira R, Perteguer-Prieto MJ. Colonic anisakiasis, an infrequent case molecularly characterised by PCR-RFLP. Enferm Infecc Microbiol Clin 2020. [PMID: 33069491 DOI: 10.1016/j.eimc.2020.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Belén González-Bertolín
- Laboratorio de Helmintos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España.
| | - Nerea Hernanz-Ruiz
- Servicio de Aparato Digestivo, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - Ramón Pérez-Tanoira
- Servicio de Microbiología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - María Jesús Perteguer-Prieto
- Laboratorio de Helmintos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España
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Ripollés T, López-Calderón LE, Martínez-Pérez MJ, Salvador J, Vizuete J, Vila R. Usefulness of Ultrasound in the Diagnosis of Intestinal Anisakiasis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1703-1708. [PMID: 32154595 DOI: 10.1002/jum.15268] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate the ultrasound (US) findings of gastrointestinal anisakiasis and the utility of US in its early diagnosis. METHODS We retrospectively assessed the imaging findings and clinical data of 21 patients with gastrointestinal anisakiasis. Diagnosis was confirmed by a positive antigen (n = 16), endoscopy (n = 2), or a compatible clinical presentation, physical examination, and history of raw fish consumption (n = 3). Ultrasound findings reviewed included segmental circumferential bowel wall thickening, segmental edema of the valvulae conniventes, dilated small bowel loops with hyperperistalsis or hypoperistalsis, free fluid, and color Doppler hyperemia. RESULTS Segmental circumferential bowel wall thickening was present in all 21 patients, whereas segmental edema of the valvulae conniventes was visualized in 13 patients, moderately dilated small-bowel loops proximal to the affected segment with increased peristalsis in 14 patients, small-to-moderate ascites in 18 patients, and color Doppler hyperemia in 7 patients. The US evaluation ruled out a surgical pathologic examination in all patients, and the diagnosis of anisakiasis was suggested by the radiologist on the basis of US findings in 12 patients. CONCLUSIONS Familiarity with the suggestive US presentation of intestinal anisakiasis may allow the radiologist to propose the diagnosis of this overlooked cause of abdominal pain and may also prompt an investigation of recent raw or lightly cooked seafood ingestion. Ultrasound findings of bowel wall thickening, especially segmental edema of the valvulae conniventes, hyperperistalsis, and dilatation of small-bowel loops proximal to the affected segment, ascites, and color Doppler hyperemia, along with a history of raw fish ingestion should aid the radiologist in the diagnosis of anisakiasis.
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Affiliation(s)
- Tomás Ripollés
- Department of Radiology, Hospital Universitario Dr Peset, Valencia, Spain
| | | | | | - Jaime Salvador
- Department of Radiology, Hospital Universitario Dr Peset, Valencia, Spain
| | - José Vizuete
- Department of Radiology, Hospital Universitario Dr Peset, Valencia, Spain
| | - Rocío Vila
- Department of Radiology, Hospital Universitario Dr Peset, Valencia, Spain
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Causes of eosinophilic ascites – A systematic review. ROMANIAN JOURNAL OF INTERNAL MEDICINE 2019; 57:110-124. [DOI: 10.2478/rjim-2018-0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
. In the last years an uprising interest for a relatively unknown entity, eosinophilic ascites (EA), has been recorded.
Our aim is to investigate the potential causes of EA development, as well as clinical, laboratory, endoscopic and radiologic features, management and outcome in these patients.
Methods
. The following research was performed on PubMed (MEDLINE) database using the medical subject headings [Mesh] terms “Ascites” AND “Eosinophils”.
Results
. A total of 284 results, dating from 1962 onwards, were found and abstracts were examined. 131 papers were excluded and the remaining 153 publications, consisting in case reports and series of cases, were analyzed.
From 171 patients with EA, 127 subjects (74%) had EGE, 17 (10%) parasitic and fungal infections, 11(7%) Hypereosinophilic syndrome and 16 patients (9%) less common diseases (eosinophilic pancreatitis, chronic eosinophilic leukemia, myelofibrosis, T-cell lymphoma, Churg Strauss Syndrome, Systemic lupus erythematosus, Familial paroxysmal polyserositis and Ménétrier’s disease). High eosinophil blood count and IgE levels as well as gastrointestinal symptoms are frequent. The diagnosis is based on ascitic fluid analysis, imaging and endoscopic biopsies. Therapy with corticosteroids results in resolution of eosinophilic ascites in almost all patients.
Conclusion
. In most cases, in the absence of allergy, parasitic infections, malignancy, hematological disorders, peritoneal tuberculosis, inflammatory bowel disease or autoimmune disease, EA develops as a manifestation of eosinophilic gastroenteritis.
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Kim HU. Anisakidosis. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2019. [DOI: 10.7704/kjhugr.2019.19.1.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Fujikawa H, Kuwai T, Yamaguchi T, Miura R, Sumida Y, Takasago T, Miyasako Y, Nishimura T, Iio S, Imagawa H, Yamaguchi A, Kouno H, Kohno H. Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report. World J Gastrointest Endosc 2018; 10:69-73. [PMID: 29564036 PMCID: PMC5852334 DOI: 10.4253/wjge.v10.i3.69] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 02/07/2018] [Accepted: 03/01/2018] [Indexed: 02/05/2023] Open
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.
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Affiliation(s)
- Hiroki Fujikawa
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Toshio Kuwai
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Toshiki Yamaguchi
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Ryoichi Miura
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Yuki Sumida
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Takeshi Takasago
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Yuki Miyasako
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Tomoyuki Nishimura
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Sumio Iio
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Hiroki Imagawa
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Atsushi Yamaguchi
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Hirotaka Kouno
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
| | - Hiroshi Kohno
- Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
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Increased number of eosinophils in ascites is associated with intestinal anisakidosis. J Helminthol 2018; 93:126-129. [DOI: 10.1017/s0022149x17001158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe aim of this study was to evaluate the association between eosinophils in ascites and the diagnosis of intestinal anisakidosis in patients with peritoneal signs on physical examination. We reviewed retrospectively 16 patients diagnosed with intestinal anisakidosis, evaluated between 2012 and 2015. All patients had ingested raw anchovies. The analysis of ascites fluid in ten of these patients was compared with that of 15 patients with ascites and other abdominal pathology (except liver cirrhosis). All patients had an increased number of white blood cells in the ascites fluid. The eosinophil count was significantly higher in patients with intestinal anisakidosis (P < 0.01). All patients had a good outcome. Increased eosinophils in ascites fluid is strongly associated with the diagnosis of intestinal anisakidosis.
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Unexpected hosts: imaging parasitic diseases. Insights Imaging 2016; 8:101-125. [PMID: 27882478 PMCID: PMC5265192 DOI: 10.1007/s13244-016-0525-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 09/08/2016] [Accepted: 09/28/2016] [Indexed: 12/28/2022] Open
Abstract
Radiologists seldom encounter parasitic diseases in their daily practice in most of Europe, although the incidence of these diseases is increasing due to migration and tourism from/to endemic areas. Moreover, some parasitic diseases are still endemic in certain European regions, and immunocompromised individuals also pose a higher risk of developing these conditions. This article reviews and summarises the imaging findings of some of the most important and frequent human parasitic diseases, including information about the parasite's life cycle, pathophysiology, clinical findings, diagnosis, and treatment. We include malaria, amoebiasis, toxoplasmosis, trypanosomiasis, leishmaniasis, echinococcosis, cysticercosis, clonorchiasis, schistosomiasis, fascioliasis, ascariasis, anisakiasis, dracunculiasis, and strongyloidiasis. The aim of this review is to help radiologists when dealing with these diseases or in cases where they are suspected. Teaching Points • Incidence of parasitic diseases is increasing due to migratory movements and travelling. • Some parasitic diseases are still endemic in certain regions in Europe. • Parasitic diseases can have complex life cycles often involving different hosts. • Prompt diagnosis and treatment is essential for patient management in parasitic diseases. • Radiologists should be able to recognise and suspect the most relevant parasitic diseases.
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Toyoda H, Tanaka K. Intestinal Anisakiasis Treated Successfully with Prednisolone and Olopatadine Hydrochloride. Case Rep Gastroenterol 2016; 10:30-5. [PMID: 27403099 PMCID: PMC4929386 DOI: 10.1159/000442971] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 12/01/2015] [Indexed: 12/13/2022] Open
Abstract
The clinical characteristic of gastrointestinal anisakiasis is severe abdominal pain after eating raw fish. Intestinal anisakiasis is more uncommon than gastric anisakiasis. Most patients with intestinal anisakiasis need hospitalization because anisakiasis can cause intestinal obstruction, ileus, peritonitis or intestinal perforation. We report a case of intestinal anisakiasis. A 43-year-old woman presented with symptoms of intermittent abdominal pain 2 days after eating raw fish. Her brother had eaten the same food and had been suffering from gastric anisakiasis. Abdominal ultrasonography in this patient showed localized jejunal wall thickening with dilated lumen of proximal jejunum and ascites. According to the clinical course and examinations, she was diagnosed with intestinal anisakiasis. Administration of prednisolone 5 mg/day and olopatadine hydrochloride 10 mg/day improved her symptoms quickly without hospitalization. Prednisolone was administered for 10 days, and olopatadine hydrochloride was administered for a total of 6 weeks according to ultrasonographic findings. Six months after the treatment, the abdominal ultrasonography demonstrated normal findings. This case demonstrates that ultrasonography was quite useful for the diagnosis and surveillance of intestinal anisakiasis. Furthermore, treatment with corticosteroid and an antiallergic agent could be an option for patients with intestinal anisakiasis.
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Affiliation(s)
| | - Kyosuke Tanaka
- Department of Endoscopic Medicine, Mie University Hospital, Tsu, Japan
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Ogata M, Tamura S, Matsunoya M. Sonographic diagnosis of intestinal anisakiasis presenting as small bowel obstruction. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:283-287. [PMID: 24962268 DOI: 10.1002/jcu.22194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 03/24/2014] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND To evaluate the accuracy of ultrasonography (US) in the diagnosis of intestinal anisakiasis presenting as small bowel obstruction. METHODS We retrospectively reviewed the clinical features, US examinations, and CT scans of seven patients with intestinal anisakiasis presenting as small bowel obstruction. We compared the performances of US and CT in demonstrating peritoneal fluid, small bowel dilatation, and segmental edema of Kerckring's folds. RESULTS All patients presented with a history of ingesting raw saltwater fish or squid less than 2 days prior to presentation at the emergency department and had significant levels of Anisakis-specific IgE. Both US and CT revealed small bowel obstruction, with dilated small bowel in all patients and accumulations of free peritoneal fluid in six patients. CT showed segmental wall thickening and luminal narrowing with submucosal edema distal to the distended small bowel; US did so in four patients. CONCLUSIONS Although US was inferior to CT in demonstrating the segmental intestinal edema causing small bowel obstruction, it can be applied in suspected cases of intestinal anisakiasis presenting as small bowel obstruction, particularly where CT is unavailable or there are concerns about radiation exposure.
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Affiliation(s)
- Masaaki Ogata
- Department of Emergency Medicine, Kobe City Medical Center West Hospital, Kobe, Japan
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Abstract
PURPOSE To evaluate the clinical and CT findings in patients with small-bowel Anisakiasis. MATERIALS AND METHODS Nineteen patients with small-bowel Anisakiasis and who underwent abdominal CT between 2005 and 2012 were enrolled in our study. All of these patients were diagnosed using either a serologic test for Anisakiasis (n = 18) or by pathology (n = 1). Their medical records were reviewed in order to determine the clinical findings. CT images were retrospectively reviewed by two radiologists to evaluate the characteristics of the involved bowel wall and the ancillary findings. RESULTS All patients had presented with the acute onset of severe abdominal pain as well as a history of having recently eaten raw fish. The mean time interval from eating the fish to the onset of abdominal pain was 1.7 days. Eighteen patients were treated conservatively and experienced resolution of their symptoms within seven days of hospitalization. One patient underwent surgical exploration for presumed small-bowel ischemia. The sites of involvement included the ileum (16/19, 84%) and jejunum (3/19, 16%). All patients had circumferential bowel-wall thickening (mean, 0.8 cm) with an intermediate length of involved bowel (mean, 7.9 cm). Small-bowel obstruction occurred in 16 patients (84%). The target sign was present in 17 patients (89%), ascites, particularly in the perilesional area, in 16 patients (84%), and mesenteric edema in 15 patients (79%). CONCLUSION Small-bowel Anisakiasis should be considered in the differential diagnosis of acute abdomen in order to avoid unnecessary surgery when patients present with abdominal pain after having recently eaten raw fish, concentric bowel-wall thickening with the target sign in the ileum, perilesional ascites, as well as bowel obstruction seen on CT.
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Abstract
Anisakidosis is a parasitic infection caused by anisakid nematodes in the genera Anisakis and Pseudoterranova. Infection is not uncommon in the United States due to increased raw seafood consumption. We report the first known case of parametrial anisakidosis in a 42-year-old woman and review existing literature.
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Barros L, Yamanaka A, Silva L, Vanzeler M, Braum D, Bonaldo J. In vitro larvicidal activity of geraniol and citronellal against Contracaecum sp (Nematoda: Anisakidae). Braz J Med Biol Res 2009; 42:918-20. [DOI: 10.1590/s0100-879x2009005000023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Accepted: 07/29/2009] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | - L.E. Silva
- Universidade Federal de Mato Grosso, Brasil
| | | | - D.T. Braum
- Universidade Federal de Mato Grosso, Brasil
| | - J. Bonaldo
- Universidade Federal de Mato Grosso, Brasil
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Kawabata H, Kimura Y, Kisa K, Murakami M, Maezawa M. Acute Intestinal Obstruction Due to Intestinal Anisakiasis Resolved with Conservative Therapy. J Rural Med 2009. [DOI: 10.2185/jrm.4.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sugita S, Sasaki A, Shiraishi N, Kitano S. Laparoscopic Treatment for a Case of Ileal Anisakiasis. Surg Laparosc Endosc Percutan Tech 2008; 18:216-8. [DOI: 10.1097/sle.0b013e318166145c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Small bowel stenosis is a serious complication of intestinal anisakiosis. The aim of this report is to investigate whether severe stenosis of the small intestine can be conservatively managed. We treated two patients with severe stenosis of the small intestine caused by anisakiosis. Surgical intervention was eventually performed on the 23rd and 35th in the hospital, respectively. Histopathological examination of the resected specimens revealed that the intestinal wall had been completely damaged by the inflammatory reaction of anisakiosis, and that the damage was irreversible, thereby suggesting that laparotomy is needed in cases of severe small bowel stenosis caused by intestinal anisakiosis, even if a long period of conservative treatment for the intestinal anisakiosis allowed the patient to pass successfully through the acute phase.
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Affiliation(s)
- Shigetoshi Matsuo
- Department of Surgery, Nagasaki Prefectural Shimabara Hospital, 7895 Shimokawajiri, Shimabara, Nagasaki 855-0861, Japan.
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Abstract
The popularity in Western countries of dishes based on raw fish has led to an increased incidence of anisakiasis, a human parasitic disease caused by the ingestion of live anisakid larvae. The entire digestive tract may be involved, but the stomach and the small intestine are the most frequently affected sites. We report a case of acute abdomen due to Anisakis simplex infection that caused small bowel obstruction.
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Affiliation(s)
- M Pellegrini
- Department of Internal Medicine, Endocrino-Metabolic Sciences and Biochemistry, University of Siena, Viale Bracci 1, 53100 Siena, Italy.
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Navarro Cantarero E, Carro Alonso B, Castillo Lario C, Fernández Gómez JA. [Diagnosis of Anisakis infestation: experience in our environment]. Allergol Immunopathol (Madr) 2005; 33:27-30. [PMID: 15777520 DOI: 10.1157/13070605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To characterize the most frequently found radiological findings in intestinal anisakiasis. MATERIAL AND METHODS The medical records of 14 patients diagnosed with intestinal anisakiasis between 2000 and 2003 in the Hospital Clinico Universitario Lozano Blesa in Zaragoza (Spain) were retrospectively reviewed. The imaging tests and immunological laboratory tests performed in these patients were evaluated. RESULTS The most frequent reason for seeking medical assistance was right iliac fossa pain. Radiological findings of an inflammatory intestinal process were observed in 60 % of the patients. Seventy-five percent of the patients had eaten raw or insufficiently cooked fish and had eosinophilia; of these 80 % had elevated specific IgE levels. CONCLUSIONS The incidence of anisakiasis is increasing and consequently knowledge of its most characteristic clinical, radiological and laboratory manifestations is important. The most frequently affected segment of the digestive tract is the ileum. Many patients have symptoms of acute abdomen, mimicking appendicitis or peritonitis. Anisakiasis is a self-limiting process that usually resolves in 1-2 weeks. Consequently, a conservative attitude is advisable to avoid unnecessary surgery.
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22
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Chinda D, Muramoto K, Shimoyama T, Sasaki H, Nara H, Munakata A. Asymptomatic colonic anisakiasis identified during colonoscopy. Dig Endosc 2004. [DOI: 10.1111/j.1443-1661.2003.00336.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Hierro I, Valero A, Pérez P, González P, Cabo MM, Montilla MP, Navarro MC. Action of different monoterpenic compounds against Anisakis simplex s.l. L3 larvae. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2004; 11:77-82. [PMID: 14971725 DOI: 10.1078/0944-7113-00375] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Different natural monoterpenes (geraniol, citronellol, citral, carvacrol, cuminaldehyde and eugenol) are studied in vitro against Anisakis simplex s.l. L3 larvae, employing perillaldehyde as a reference substance. Final concentrations used were: 12.50, 6.25 and 3.12 microg/ml for each of the tested products. The parameters average survival, survival 50 and maximum survival were determined at 4, 8, 24 and 48 hours after the start of the experiment. All tested products, except eugenol, were active at the highest concentration (12.50 microg/ml). The damage caused to A. simplex s.l. L3 was by examining histological sections. The antioxidant activity of the tested products by DPPH free radical scavenging does not appear to be associated with their larvicide activity against A. simplex s.l. L3.
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Affiliation(s)
- I Hierro
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja, Granada, Spain
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24
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25
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Caramello P, Vitali A, Canta F, Caldana A, Santi F, Caputo A, Lipani F, Balbiano R. Intestinal localization of anisakiasis manifested as acute abdomen. Clin Microbiol Infect 2003; 9:734-7. [PMID: 12925120 DOI: 10.1046/j.1469-0691.2003.00660.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Anisakis pathology is due mainly to two mechanisms: allergic reactions (from isolated urticaria and angioedema to life-threatening anaphylactic shock associated with gastrointestinal symptoms or 'gastroallergic anisakiasis'), and direct tissue damage, due to invasion of the gut wall, development of eosinophilic granuloma, or perforation (gastric or intestinal anisakiasis). Anisakiasis is a misdiagnosed and underestimated cause of acute abdomen: most patients undergo laparotomy, and virtually no cases are diagnosed before surgery. In some cases, diagnosis is obtained accidentally during other pathologic investigations. We report a case of acute abdomen due to terminal ileum involvement. Microscopic examination of the resected segment showed the presence of helminthic sections consistent with larvae of Anisakis spp. A history of raw fish ingestion was recorded. Histopathologic features are illustrated. A short but up-to-date review of the literature on diagnostic devices (particularly imaging and serology), clinical aspects and therapy is presented.
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Affiliation(s)
- P Caramello
- Infectious Diseases Unit 'A', Ospedale Amedeo di Savoia, C.so Svizzera 164, 10149 Torino, Italy.
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26
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Repiso Ortega A, Alcántara Torres M, González de Frutos C, de Artaza Varasa T, Rodríguez Merlo R, Valle Muñoz J, Martínez Potenciano JL. [Gastrointestinal anisakiasis. Study of a series of 25 patients]. GASTROENTEROLOGIA Y HEPATOLOGIA 2003; 26:341-6. [PMID: 12809570 DOI: 10.1016/s0210-5705(03)70370-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Infection with the parasite Anisakis simplex is common in Japan and northern European countries. The number of reported cases in Spain has increased since the first description in 1991. The aim of the present study was to evaluate the incidence, clinical patterns, histopathological lesions, treatment, and outcome of Anisakis simplex infection in our environment. MATERIAL AND METHOD Cases of gastrointestinal anisakiasis diagnosed in our center from December 1999 to January 2002 were studied. Only patients with detection of the parasite in oral endoscopy or the surgical specimen and those with elevated levels of specific IgE to Anisakis simplex, a clinical picture compatible with anisakiasis, or a history of raw fish intake were included. Epidemiological, clinical and laboratory data, as well as diagnostic, histopathologic and therapeutic features, and outcome in these patients were recorded. RESULTS Twenty-five cases of gastrointestinal anisakiasis were diagnosed during the study period, representing an incidence of 3.87 cases per 100 000 inhabitants/year. All the patients had ingested raw anchovies. Two groups were observed. The first group was composed of 10 patients with a gastric form of the infection, in which the main symptom was epigastralgia (90%). Oral endoscopy was performed in all patients and the parasite was detected in five (50%). The second group was composed of 15 patients with intestinal involvement in which the main manifestations were symptoms mimicking appendicitis (80%). The most frequent finding of laparotomy and/or imaging tests (abdominal ultrasonography, intestinal transit, abdominal CAT) was terminal ileitis (80%). Seven patients underwent surgery: intestinal resection was performed in four with detection of Anisakis simplex in three. Eosinophilic infiltration was found in all surgical specimens. Treatment was symptomatic in most of the patients and outcome was favorable in all. CONCLUSIONS Infection with Anisakis simplex should be investigated in patients with abdominal pain after intake of raw fish, ileitis of unclear origin, or eosinophilic gastroenteritis.
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Affiliation(s)
- A Repiso Ortega
- Servicio de Aparato Digestivo. Hospital Virgen de la Salud. Toledo. España.
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Abstract
The nematode Anisakis simplex (AS) is a world wide distributed parasite that infects consumers of raw or undercoocked parasitized fish. The clinical manifestation of Anisakiosis depend on the site in the digestive tract in which larva lodges. The symptoms develops as a result of the inflammation when the larvae penetrates the gastric mucous. Most of asymptomatic subjects show high levels of specific IgE to AS. Diagnosis of AS allergy is not simple, due to cross-reactivity with other allergens. In childhood is more difficult to make a right diagnosis than in adult population. Most of positive prick test to AS correspond to children with positive prick tests to other allergens. Cross-reactivity between this parasite and other parasites with a higher prevalence in childhood, is the cause of a false diagnosis. The secretor-excretory antigen shows a better specificity, recognizing the true parasitized patients. This antigen could be used as indicator of parasitization. To follow prevention rules AS, avoid consumption of raw fish unless frozen for 48 hours or ingestion of fresh fish always cooked for more than 20 minutes at least at 60 C.
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Affiliation(s)
- A Valls
- Servicio de Alergología, Hospital Universitario La Paz, Madrid, Spain
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28
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Muñoz S, Nuevo JA, Ruiz M, González-Castillo J, Cubo P, Burón MR. [Acute abdominal pain and ascites in a young woman]. Enferm Infecc Microbiol Clin 2002; 20:365-7. [PMID: 12237004 DOI: 10.1016/s0213-005x(02)72816-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sonia Muñoz
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España.
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Affiliation(s)
- A Ishiguro
- First Department of Internal Medicine, Hirosaki University School of Medicine, Hirosaki, Japan
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López Peñas D, Ramírez Ortiz LM, del Rosal Palomeque R, López Rubio F, Fernández-Crehuet Navajas R, Miño Fugarolas G. [Study of 13 cases of anisakiasis in the province of Cordoba]. Med Clin (Barc) 2000; 114:177-80. [PMID: 10738724 DOI: 10.1016/s0025-7753(00)71235-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Anisakiasis, or anisakidosis, is a parasitic zoonosis due to the infestation by nematodes of the Anisakidae family, mainly by Anisakis simplex. Notwithstanding its world wide distribution, in our country its appearance is quite recent (1991) with only 19 cases previously reported. We refer 13 cases diagnosed in different hospitals in the province of Córdoba, Spain, from September 1994 to July 1998 which represents the biggest series described in Spain so far. All the patients had a clinical onset as acute abdomen, so that they required early surgery in which a narrowing and inflammatory intestinal segment was observed and subsequently resected. Pathology revealed in such segments an intense eosinophilic infiltrate in the mucosa. Only in one of the cases parasitic fragments were detected in the intestinal mucosa and in the 12 remaining cases the diagnosis was immunological by IgE specific for Anisakis simplex determination and antigens detection of the nematode with monoclonal antibodies. As interesting epidemiologic antecedent we shall mention the fact that all patients referred a usual raw fish consumption (mainly anchovy with vinegar) which is host of third-stage larval of the parasite.
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Affiliation(s)
- D López Peñas
- Unidad Clínica de Aparato Digestivo, Hospital Reina Sofía de Córdoba
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Ledermann HP, Börner N, Strunk H, Bongartz G, Zollikofer C, Stuckmann G. Bowel wall thickening on transabdominal sonography. AJR Am J Roentgenol 2000; 174:107-17. [PMID: 10628464 DOI: 10.2214/ajr.174.1.1740107] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- H P Ledermann
- Department of Radiology, University Hospital of Basel, Switzerland
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Abstract
Patients with hereditary angioedema (HAE) may suffer from abdominal pain severe enough to prompt unnecessary surgical intervention. The diagnostic approach to abdominal pain during HAE attacks is not established. We describe abdominal sonographic findings during severe colic in 2 patients with known HAE. Sonography demonstrated marked mucosal thickening and edema of the bowel wall with a variable amount of free peritoneal fluid. These findings are not specific but are consistent with the hypothesized mechanism of attack and resolve after therapy. Abdominal sonography is useful for evaluating acute abdominal pain in patients with known HAE to prevent unnecessary surgery. Conversely, if the described sonographic findings appear in a case of abdominal colic of unknown origin, HAE should be included in the differential diagnosis.
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Affiliation(s)
- S Sofia
- Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Ospedale S. Orsola-Malpighi, Via Albertoni 15, 40128 Bologna, Italy
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Muguruma N, Okamura S, Okahisa T, Shibata H, Ito S, Terauchi A. Anisakis larva involving the esophageal mucosa. Gastrointest Endosc 1999; 49:653-654. [PMID: 10228271 DOI: 10.1016/s0016-5107(99)70401-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- N Muguruma
- Second Department of Internal Medicine, School of Medicine, University of Tokushima, and Saito Hospital, Tokushima, Japan
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Ido K, Yuasa H, Ide M, Kimura K, Toshimitsu K, Suzuki T. Sonographic diagnosis of small intestinal anisakiasis. JOURNAL OF CLINICAL ULTRASOUND : JCU 1998; 26:125-130. [PMID: 9502034 DOI: 10.1002/(sici)1097-0096(199803/04)26:3<125::aid-jcu3>3.0.co;2-o] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE We studied the utility of sonography in the early diagnosis of anisakiasis of the small intestine. METHODS The imaging findings and clinical data of 12 patients with proven small intestinal anisakiasis were retrospectively reviewed. RESULTS Dominant sonographic findings were ascites, small bowel dilatation, and focal edema of Kerckring's folds. CONCLUSIONS Patients who have acute abdomen after recent ingestion of seafood and in whom ascites, small bowel dilatation, and focal edema of Kerckring's folds are seen by sonography should be suspected of having small intestinal anisakiasis and should be treated conservatively without laparotomy.
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Affiliation(s)
- K Ido
- Department of Surgery, Nagoya Tokushukai General Hospital, Aichi Prefecture, Japan
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