title: Sonographic diagnosis of intestinal anisakiasis presenting as small bowel obstruction.
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.
authors: Department of Emergency Medicine, Kobe City Medical Center West Hospital, Kobe, Japan.
authors: Masaaki
authors: M
authors: Ogata
authors: Shuji
authors: S
authors: Tamura
authors: Michiko
authors: M
authors: Matsunoya
mesh_terms: D000006:Abdomen, Acute; D000368:Aged; D017129:Anisakiasis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000469:parasitology*; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: CT; abdomen; intestinal anisakiasis; parasitic infection; small bowel obstruction; ultrasonography