Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2018; 10(3): 69-73
Published online Mar 16, 2018. doi: 10.4253/wjge.v10.i3.69
Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report
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
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
Processing time: 63 Days and 22.8 Hours
ARTICLE HIGHLIGHTS
Case characteristics

A 59-year-old Japanese woman who had eaten sliced raw horse mackerel and salmon at lunch presented with epigastric pain and vomiting since the evening.

Clinical diagnosis

Tenderness in the epigastrium without obvious rebound tenderness or guarding.

Differential diagnosis

Acute abdomen including digestive disorders and gynecological disorders, acute coronary syndromes, urinary system diseases.

Laboratory diagnosis

All labs were within normal limits, except for increased C-reactive protein (19.7 mg/dL).

Imaging diagnosis

Computed tomography (CT) scan demonstrated segmental edema of the intestinal wall with dilated bowel and a small number of ascites, and endoscopy revealed that nine Anisakis larvae were attached to the gastric mucosa.

Treatment

Direct endoscopic removal of all of the Anisakis larvae in the stomach with a biopsy forceps and Gastrografin administration for enteric anisakiasis.

Experiences and lessons

Abdominal CT is useful for the diagnosis of enteric anisakiasis and Gastrografin administration therapy is useful for the extraction of enteric Anisakis larvae.