Ann Surg Treat Res.  2014 May;86(5):270-273. 10.4174/astr.2014.86.5.270.

Chronic gastric anisakiasis provoking a bleeding gastric ulcer

• Kang DB
• Park WC
• Lee JK

• KMID: 1889665
• DOI: http://doi.org/10.4174/astr.2014.86.5.270

Abstract

Gastric anisakiasis is a parasitic disease caused by the gastric mucosal penetration of the Anisakis larvae ingested with raw fish. Acute gastric anisakiasis is diagnosed by the endoscopic visualization of Anisakis larvae along with mucosal edema, erythema, hemorrhage, and/or an ulcer, whereas chronic anisakiasis is often observed as a localized tumor commonly occurring in the submucosal layer, and is characterized by eosinophilic granuloma with edema and embedded Anisakis larvae on pathological examination of surgical specimens. We report here a case of chronic gastric anisakiasis provoking a bleeding gastric ulcer, which is a rare clinical manifestation of this condition.

Keyword

Anisakiasis; Hemorrhage; Stomach

MeSH Terms

Anisakiasis*
Anisakis
Edema
Eosinophilic Granuloma
Erythema
Hemorrhage*
Larva
Parasitic Diseases
Stomach
Stomach Ulcer*
Ulcer

Figure

• 

  Fig. 1 Endoscopic view shows central ulcer on submucosal tumor-like lesion with surrounding mucosal edema on greater curvature of gastric midbody.

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  Fig. 2 Abdominal CT shows localized and inhomogeneous enhanced submucosal mass of approximately 3 cm in size on greater curvature of gastric midbody (arrow).

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  Fig. 3 Endoscopic ultrasonography shows 3-cm- × 2.5-cm-sized heterogeneous submucosal mass on greater curvature of gastric midbody (arrow).

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  Fig. 4 Histopathological examination shows severe inflammatory cell infiltration, edema, and abscess formation with submucosal eosinophilic granuloma surrounding larva, which are typical findings of gastric anisakiasis (A: H&E, ×1; B: H&E, ×200).

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