Year 2026 / Volume 118 / Number 3
Letter
Computed tomographic and endoscopic findings of multiple gastric anisakiasis

176-177

DOI: 10.17235/reed.2024.10935/2024

Yuko Tasato, Hiroaki Komesu, Mayumi Shiroma, Mami Tomiyama, Hitoshi Mabuchi, Masaru Miyazato, Ryosaku Tomiyama, Akira Hokama,

Abstract
A 36-year-old man presented with sudden onset of severe abdominal pain. A CT scan was performed first, which showed marked thickening of the gastric wall. Gastric anisakiasis was suspected because he had eaten sashimi (a raw fish dish), including salmon and tuna, the night before. An upper gastrointestinal endoscopy revealed three Anisakis larvae invading the gastric wall. All larvae were removed by the biopsy forceps. His symptoms were resolved after the removal. Anisakiasis is a gastrointestinal parasitic infection of humans caused by ingestion of raw or undercooked seafood containing Anisakis larvae, resulting in severe gastrointestinal disorders and allergic reactions. Salmon, herring, cod, mackerel, squid, and flounder are known intermediate hosts. Cases of anisakidosis are increasing globally. Although gastric anisakiasis is a relatively common disease in Japan, it is unusual to find marked thickening of the gastric wall on CT scans and multiple anisakiasis on upper endoscopy, as shown in this case. Our case highlights the importance of a careful history leading to prompt diagnosis and treatment of gastric anisakiasis in cases presenting with acute onset of severe abdominal pain several hours after ingestion of raw or undercooked seafood. Healthcare professionals and edible seafood handlers should increase their awareness of fish parasites. Proper freezing or cooking of seafood is an important prophylactic measure.
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References
1. Shamsi S, Barton DP. A critical review of anisakidosis cases occurring globally. Parasitol Res. 2023;122:1733-45. doi: 10.1007/s00436-023-07881-9.
2. Fornell Pérez R, Urizar Gorosarri M, Pérez Bea M. Anisakiasis: Imaging findings. Radiologia (Engl Ed). 2022;64:245-55. doi: 10.1016/j.rxeng.2022.05.001.
3. Hokama A, Oshiro T, Tomisato K, et al. Gastric anisakidosis: an unfavorable taste of sushi. Pol Arch Intern Med. 2019;129:547-8. doi: 10.20452/pamw.14838.
4. Bartra Balcells È, Domènech Calvet J, Del Castillo Déjardin D. Intestinal obstruction caused by Anisakis. Rev Esp Enferm Dig. 2021;113:547. doi: 10.17235/reed.2020.7409/2020.
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Tasato Y, Komesu H, Shiroma M, Tomiyama M, Mabuchi H, Miyazato M, et all. Computed tomographic and endoscopic findings of multiple gastric anisakiasis . 10935/2024


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Publication history

Received: 11/11/2024

Accepted: 25/11/2024

Online First: 04/12/2024

Published: 06/03/2026

Article Online First time: 23 days

Article editing time: 480 days


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