title: Three successive cases of enteric anisakiasis.
abstract: Enteric anisakiasis is relatively rare, and the preoperative diagnosis is difficult. We report 3 cases of enteric anisakiasis: 1 was confirmed by operation, and the other 2 cases were suspected by the patient history. The 1st patient was a 48-year-old female presenting with abdominal pain. An abdominal computed tomography scan showed a dilated small intestine and accumulation of ascites. We performed partial resection of the small intestine, and an Anisakis nematode was found on the wall of the resected bowel. After surgery, the detailed history revealed that the patient consumed a raw sardine with vinegar and miso, fermented soybean paste. Three days after her operation, 2 men presenting with abdominal pain visited the hospital, and computed tomography scans of the patients showed dilated small intestines and accumulation of ascites. By taking patient histories, we found that both of them consumed sardines with vinegar and miso, and both were given conservative treatment with fasting and transfusion. By the experience of the 1st case, we could diagnose the following 2 cases as having enteric anisakiasis. In conclusion, the possibility of anisakiasis should be considered in patients with abdominal pain after ingesting raw fish, especially when intestinal obstruction is suspected.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Tohoku University, Sendai, and Department of Surgery, Gonohe General Hospital, Japan. mishida@surg1.med.tohoku.ac.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishida
authors.forename: Akihiko
authors.initials: A
authors.lastname: Harada
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Watabe
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ebina
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000368:Aged; D000818:Animals; D017129:Anisakiasis / Q000150:complications* / Q000175:diagnosis; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis / Q000469:parasitology; D005260:Female; D005396:Fish Products / Q000506:poisoning; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000469:parasitology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000469:parasitology* / Q000601:surgery; D007814:Larva; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome