Korean J Gastrointest Endosc.  1999 Jun;19(3):445-448.

A Case of Acute Gastric Anisakiasis Causing Massive Hematemesis

• Chang R
• Chang YW
• Kim BH
• Kim HJ
• Dong SH
• Lee JI
• Kim KJ
• Hwang IS
• Park CY
• Kang SW

Abstract

Acute gastric anisakiasis is caused by gastric mucosal penetration from an Anisakis larvae. It occurs with those who ingest raw or inadequately cooked saltwater fish or squid containing anisakis. The clinical symptoms are severe abdominal pain, nausea, vomiting, diarrhea, and so on. A case of acute gastric Anisakiasis with massive hematemesis was presented. Initial endoscopic examination revealed an edematous or raised erosive lesion with a small blood clot-covered vessel in the fundus which was thought to be a stigmata of recent bleeding. The lesion was treated with an epinephrine-hypertonic saline injection, electrocoagulation, and an ethanol injection. A follow-up gastroscopy revealed an artificial coagulation-induced ulcer at the previous bleeding site. At the ulcer margin, a whitish linear worm was found with half of its body penetrating the gastric mucosa. The worm was removed using biopsy forceps and the patient was subsequently placed on a soft diet. The next day however, hematemesis recurred. Gastroscopic band ligation of the vessel was performed with a cessation of bleeding. Three weeks later, a gastroscopy determined that the ulcer had completely healed.

Keyword

Anisakis; Endoscopy; Hematemesis

MeSH Terms

Abdominal Pain
Anisakiasis*
Anisakis
Biopsy
Christianity
Decapodiformes
Diarrhea
Diet
Electrocoagulation
Endoscopy
Ethanol
Follow-Up Studies
Gastric Mucosa
Gastroscopy
Hematemesis*
Hemorrhage
Humans
Larva
Ligation
Nausea
Surgical Instruments
Ulcer
Vomiting
Ethanol