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(3): 69-73 [PMID: 29564036 DOI: 10.4253/wjge.v10.i3.69]
Corresponding Author of This Article
Toshio Kuwai, MD, PhD, Chief Doctor, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Japan. kuwait@kure-nh.go.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hiroki Fujikawa, Toshio Kuwai, Toshiki Yamaguchi, Ryoichi Miura, Yuki Sumida, Takeshi Takasago, Yuki Miyasako, Tomoyuki Nishimura, Sumio Iio, Hiroki Imagawa, Atsushi Yamaguchi, Hirotaka Kouno, Hiroshi Kohno, Department of Gastroenterology, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure 737-0023, Japan
Author contributions: Kuwai T assessed the patients; Fujikawa H and Yamaguchi T wrote the manuscript; Nishimura T and Iio S assisted in performing the diagnostic tests; Miura R, Sumida Y, Takasago T, and Miyasako Y interpreted the data; Imagawa H, Yamaguchi A, Kouno H, and Kohno H critically reviewed the manuscript.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Toshio Kuwai, MD, PhD, Chief Doctor, Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure 737-0023, Japan. kuwait@kure-nh.go.jp
Telephone: +81-823-223111 Fax: +81-823-210478
Received: July 14, 2017 Peer-review started: July 16, 2017 First decision: January 15, 2018 Revised: January 20, 2018 Accepted: March 1, 2018 Article in press: March 1, 2018 Published online: March 16, 2018
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.
Core tip: Enteric anisakiasis is difficult to diagnose due to a lack of definitive criteria, and there is currently no curative treatment. This case report describes two important clinical suggestions: (1) Abdominal computed tomography (CT) is useful for the diagnosis of enteric anisakiasis; and (2) Gastrografin administration is a safe, convenient, and useful therapy. In the case of intestinal anisakiasis, CT scan showed submucosal edema of the intestine with proximal dilatation and ascites. We performed ileography using Gastrografin to extract enteric Anisakis larvae after placing an ileus tube, which led to shortened hospital stay.
