A Case of Chronic Gastric Eosinophilic Abscess Treated by Endoscopic Submucosal Dissection / 대한소화기내시경학회지

Anisakiasis is a parasitic disease caused by ingestion of raw fish infected with anisakis larvae. The endoscopic features of the gastic mucosa are edema, ulceration and hemorrhage. Chronic gastric anisakiasis forming a submucosal tumor is rare. A 53-year old female was diagnosed with having a 1 cm sized gastric submucosal mass-like lesion by gastroscopy. Endoscopic ultrasonography showed an inhomogenous low echoic tumor with an irregular margin in the submucosal layer. The patient underwent an endoscopic submucosal dissection and band ligation. A serological assay with an enzyme-linked immunosorbent assay for an anisakiasis specific IgG antibody were positive. The pathological finding of the resected mass was centrally denatured larvae with eosinophilic abscess in the submucosal layer. We report a case of chronic gastric anisakiasis that presented as a gastric submucosal tumor that was removed by the endoscopic submucosal dissection method, with a review of the relevant literature.

A Case of Anisakiasis Concurrently Invading Esophagus and Stomach, and Another Case of Esophageal Anisakiasis / 대한소화기내시경학회지

Human anisakiasis may occur after ingestion of raw marine fish infected with the nematode larvae of Anisakidae. Clinical symptoms such as cramping abdominal pain, nausea, vomiting, diarrhea and epigastric fullness, usually develop within 12 hours after having eaten infected raw sea fish. Anisakiasis is most commonly found in the stomach, and is rarely identified in the small intestine, large intestine, and esophagus. We report two cases of of anisakiasis, one with concurrent invasion of the stomach and esophagus, and the other case with esophageal anisakiasis. Both were treated by endoscopic extraction of the larvae.

A case of acute gastric anisakiasis provoking severe clinical problems by multiple infection

Acute gastric anisakiasis with multiple anisakid larvae infection is reported. A 68-year-old woman residing in Busan, Korea, had epigastric pain with severe vomiting about 5 hours after eating raw anchovies. Four nematode larvae penetrating the gastric mucosae in the great curvature of the middle body and fundus were found and removed during gasteroendoscopic examination. Another one thread-like moving larva was found in the great curvature of upper body on the following day. On the basis of their morphology, the worms were identified as the 3rd stage larvae of Anisakis simplex. This case is acute gastric anisakiasis provoking severe clinical problems by the multiple infection and the greatest number of anisakid larvae found in a patient in Korea.

Endoscopic Findings of Acute Gastric Anisakiasis: Thirty-nine cases in Inchon City / 대한소화기내시경학회지

BACKGROUND AND AIMS: When acute gastric anisakiasis is clinically suspected, endoscopic removal of larva is the only definite treatment method. However, there has been little known for endoscopic findings of gastric anisakiasis. METHODS: In 39 patients with gastric anisakiasis, the ingested species of marine products and clinical findings were investigated. The form of larvae, the mucosal changes of the insertion site, close and distant area were also analysed during endoscopic examination. RESULTS: Twelve patients (30.8%) ate raw Astroconger myriaster solely, and the most frequent mucosal insertion site of larvae was around the greater curvature of the body (59.5%). Endoscopic findings of erosion (33.3%), hemorrhagic erosion (33.3%) and redness of the mucosa (11.9%) were observed at the insertion site. The adjacent mucosal changes were edema and fold enlargement. All patients were treated medically. CONCLUSIONS: When acute gastric anisakiasis is suspected, the careful endoscopic examination of larva was necessary for confirmatory diagnosis and definite treatment of the disease.

A Case of Gastric Anisakiasis Causing Mallory - Weiss Syndrome / 대한소화기내시경학회지

Anisakiasis is an infection in humans caused by larval nematodes of the family Anisakidae and is encountered in people who eat inadequately prepared raw, salt-water fish or "sashimi". This clinical syndrome is characterized by severe cramping abdominal pain, nausea, and vomiting. Because Koreans like to eat raw fish, anisakiasis of the stomach has been reported occasionally, but the incidences of upper gastrointestinal bleeding caused by anisakiasis has been very rare. The present case is a 30 year-old male Admitted with an episode of hematemesis. A gastrofibroscopy revealed a mucosal laceration and the larva of Anisakis on the esophagogastric junction. We report one case of Mallory-Weiss Syndrome due to gastric Anisakis larva, confirmed by an endoscopy.

A Case of Parasitic Eosinophilic Granuloma of the Stomach Presenting with Upper Gastrointestinal Bleeding / 대한소화기내시경학회지

The localized eosinophilic granulomatous lesions of the stomach are rare benign tumorous conditions resembling submucosal tumors. They can be divided into two types. One is an inflammatory fibroid polyp. The other is an eosinophilic granuloma due to migration of Anisakis-type larva in the alimentary tract. The latter is usually found in the gastric body and anterior wall of the angle, and appears as a submucosal tumor. Histologically, the granuloma exhibits a characteristic lamellated structure consisting of a necrotic center with or without the worm, surrounded by layers of granulation tissue and eosinophilic infiltration. The present case is a 50 year-old male presenting with an episode of profuse melena. An emergency esophagogastroduodenoscopy revealed a 2x1.5cm sized, irregularly shaped ulcerative lesion with elevated margins and prominent folds convergence. Despite the endoscopic injection of hypertonic saline-epinephrine solution due to a recent bleeding stigmata, the patient experienced a rebleeding during hospitalization, The locally excised specimen showed an eosinophilic granuloma having a central necrosis. Although the larval body of Anisakis was not found, the lesion was diagnosed as a parasitic eosinophilic granuloma of the stomach.

A Case of Gastric Anisakiasis Causing Severe Gastric Ulcer Bleeding / 대한소화기내시경학회지

Anisakiasis is a parasitic infectious disease caused by eating raw, infected fish. It causes severe abdominal pain-like acute abdomen, but not fatal. Anisakiasis was firstly reported by van Thiel et al. in 1960 in Netherlands and it has subsequently been reported in the Netherlands, Japan, the United states, Korea as well as other nations. Because Koreans like eating raw fish, the anisakiasis of the stomach was occasionally reported, but the case of severe gastric bleeding was very rare. So we report one case of gastric ulcer bleeding due to gastric anisakis larva proven by endoscopy and gastric resection.

Acute Gastric Anisakiasis: A case report

We report a case of a 41-year-old female patient who suffered from the acute abdominal pain for several hours after eating raw sea-fishes. After the fibergastroscopy and the abdominal C-T scan, the clinicians found a gastric submucosal mass and performed the explolaparotomy to get an wedge of stomach. Sections revealed a larva surrounded by phlegmonous inflammation with intense eosinophilic infiltration in the widened gastic submucosa. The larva presented the characteristics of the Anisakis: two lateral chords with renette cell, thich smooth cuticle and well developed musculature.