A 17-year-old boy urgently visited a regional hospital due to severe abdominal pain. He had eaten raw fish the day before. On evaluation, his blood examination was normal and abdominal computed tomography showed thickening of the stomach wall. Hence, he was referred to our hospital for emergency endoscopy. Esophagogastroduodenoscopy showed several anisakis in the greater curvature of the gastric body (Fig. 1a), which were removed endoscopically. A close look at the stomach revealed several other anisakis (Fig. 1b). A total of 10 anisakis was found and removed from the stomach (Fig. 2). Thereafter, his symptoms disappeared.
Our experience suggests that anisakiasis is important in the differential diagnosis of acute abdomen. Gastrointestinal anisakiasis is an infectious disease that causes sudden abdominal pain when larvae pierce the wall of the gastrointestinal tract several hours after eating raw fish, such as mackerel and squid. In general, the symptoms differ depending on the immune response of anisakis, and anisakiasis is divided into acute and chronic anisakiasis. The most common site of anisakis insertion is the greater curvature of the gastric body, which is seen as white lint-like larva about 2 cm long in the gastric wall, along with redness of the mucosa.
Ethics statementThe patients provided informed written consent to undergo the procedure.
DisclosureAll authors disclosed no financial relationship relevant to this publication.
