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, 7 (1), 23-9

Comparison of the Clinical Characteristics of Patients With Small Bowel and Gastric Anisakiasis in Jeju Island

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Comparison of the Clinical Characteristics of Patients With Small Bowel and Gastric Anisakiasis in Jeju Island

Taeyun Kim et al. Gut Liver.

Abstract

Background/aims: Anisakiasis is frequent in Jeju Island because of the people's habit of ingesting raw fish. This study evaluated the clinical characteristics of patients with small bowel anisakiasis and compared them with those of patients with gastric anisakiasis.

Methods: We retrospectively reviewed the medical records of 109 patients diagnosed with anisakiasis between May 2003 and November 2011.

Results: Of the 109 patients diagnosed with anisakiasis, those with suspicious anisakiasis (n=38) or possible anisakiasis (n=12) were excluded. The age and gender distributions did not differ between patients with small bowel anisakiasis (n=30; age, 45±13 years) and those with gastric anisakiasis (n=29; age, 46±10 years). The mean duration of hospitalization was 5.4±4.3 days for patients with small bowel anisakiasis and 0.5±1.7 days for patients with gastric anisakiasis. Small bowel anisakiasis was accompanied by leukocytosis (76.7% vs 25.5%, p=0.003) and elevated C-reactive protein levels (3.4±3.2 mg/dL vs 0.5±0.3 mg/dL, p=0.009). Contrast-enhanced abdominopelvic computed tomography showed small bowel wall thickening with dilatation in 93.3% (28/30) of patients and a small amount of ascites in 80.0% (24/30) of patients with small bowel anisakiasis.

Conclusions: Compared with gastric anisakiasis patients, small bowel anisakiasis patients had a longer hospitalization time, higher inflammatory marker levels, and small bowel wall thickening with ascites.

Keywords: Anisakiasis; Characteristics; Small intestine; Stomach.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Overview of eligible adult patients and diagnostic criteria for anisakiasis. Typical computed tomography (CT) findings: 1) concentric bowel wall thickening or a target sign and 2) ascites. IgE, immunoglobulin E.
Fig. 2
Fig. 2
Small bowel anisakiasis involving the right lower quadrant of the ileum. (A) A contrast-enhanced abdominal-pelvic computed tomography (CT) image through the mid-abdominal level showing diffuse concentric small bowel wall thickening with a target sign (arrow) and proximal small bowel dilatation. (B) A contrast-enhanced abdominal-pelvic CT image through the pelvis showing a small amount of ascites in the pelvic cavity.
Fig. 3
Fig. 3
Small bowel segmental resection in a patient with small bowel anisakiasis. (A, B) The resected small bowel specimen (approximately 30 cm) showing the penetration of an Anisakis larva into the bowel wall (yellow arrow). (C) H&E-stained cross section showing two larvae (black arrows) surrounded by a thick cuff of acute inflammatory cells with numerous eosinophils (×200). (D) High-power view of a cross section through a larva (H&E stain, ×400). M, muscle layer; LC, lateral chord; I, intestine.

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