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Fornell-Perez R, Urizar-Gorosarri M, Martinez-Urabayen U, Perez-Bea M. Evaluation of imaging findings in gastrointestinal anisakiasis in emergency CT and ultrasound. Insights Imaging 2023; 14:187. [PMID: 37953399 PMCID: PMC10641062 DOI: 10.1186/s13244-023-01511-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/27/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND To assess the frequency of appearance of various signs (isolated and grouped) in emergency imaging tests in patients with anisakiasis, according to the location of gastrointestinal tract involvement. METHODS Retrospective review by two experienced radiologists of emergency ultrasounds and CTs performed on patients admitted in the Emergency Department of our hospital with later confirmed anisakiasis (2010-2021), assessing the presence of signs suggesting anisakiasis. Calculation of the frequency of appearance according to the gastric or intestinal location, as well as the most common grouped signs. RESULTS Out of 231 total patients with anisakiasis, imaging studies were performed in 144: abdominopelvic ultrasound in 43 cases and CT in 111 (both techniques in 31). In cases with gastric occurrence (34), in CT the wall stratification (100%), wall thickening (97%), fat stranding (91%) and ascitic fluid (82%) were predominant. In the intestinal cases (105), in CT (95) the wall thickening (100%), fat stranding (92%) and mesenteric vessel engorgement (83%) were usual; in ultrasound (40), ascitic fluid and wall thickening (70% in both cases) were frequently observed. The frequency of grouped appearance of the mentioned signs was 82% in gastric cases, 80% in intestinal cases and 50% in ultrasounds. Multisegment involvement in CT reached 28% (gastric + intestinal) and 11% (only intestinal) of cases. CONCLUSIONS The most frequent CT findings in patients with gastric anisakiasis are wall stratification and thickening, fat stranding and ascitic fluid. In the intestinal cases, wall thickening, fat oedema and vessel engorgement are the most often observed findings. CRITICAL RELEVANCE STATEMENT The presence of different radiological signs makes it advisable to include anisakiasis in the differential diagnosis of acute abdomen. Intestinal and multifocal involvement rates are greater than previously reported. KEY POINTS • In gastric anisakiasis, CT frequently shows wall stratification and thickening, fat stranding and ascitic fluid. • In intestinal anisakiasis, CT often presents wall thickening, fat stranding and vessel engorgement. • In intestinal anisakiasis, ultrasounds most frequently show ascitic fluid and wall thickening.
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Affiliation(s)
| | | | | | - Marta Perez-Bea
- Radiology Department, Basurto Universitary Hospital, Bilbao, Vizcaya, Spain
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Okagawa Y, Sumiyoshi T, Imagawa T, Sakano H, Tamura F, Arihara Y, Kanari Y, Sakurada A, Oiwa S, Jin T, Tomita Y, Minami S, Hisai H, Muramatsu H, Katsuki S, Maeda M, Kondo H. Clinical factors associated with acute abdominal symptoms induced by gastric anisakiasis: a multicenter retrospective cohort study. BMC Gastroenterol 2023; 23:243. [PMID: 37464307 DOI: 10.1186/s12876-023-02880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Gastric anisakiasis typically causes severe abdominal symptoms; however, we incidentally detected asymptomatic gastric anisakiasis cases during esophagogastroduodenoscopy. The factors associated with developing acute abdominal symptoms induced by gastric anisakiasis remain unclear. Therefore, this study aimed to investigate the clinical factors associated with abdominal symptoms of gastric anisakiasis by comparing symptomatic and asymptomatic cases. METHODS This was a retrospective cohort study involving 264 patients diagnosed with gastric anisakiasis at nine hospitals in Japan between October 2015 and October 2021. We analyzed patients' medical records and endoscopic images and compared the clinical factors between the symptomatic and asymptomatic groups. RESULTS One hundred sixty-five patients (77.8%) were diagnosed with abdominal symptoms, whereas 47 (22.2%) were asymptomatic. Older age, male sex, diabetes mellitus, gastric mucosal atrophy, and gastric mucosal atrophy of the Anisakis penetrating area were significantly more common in the asymptomatic group than in the symptomatic group. Multivariate analysis revealed that age (p = 0.007), sex (p = 0.017), and presence or absence of mucosal atrophy (p = 0.033) were independent factors for the occurrence of acute abdominal symptoms. In addition, cases that were Helicobacter pylori naïve, with an elevation of white blood cells, or without an elevation of eosinophils were more common in the symptomatic group than in the asymptomatic group. CONCLUSIONS Age, sex, and presence or absence of gastric mucosal atrophy were the clinical factors associated with the occurrence of acute abdominal symptoms. Older and male patients and those with gastric mucosal atrophy were less likely to show abdominal symptoms. The mechanisms of the occurrence of symptoms induced by gastric anisakiasis remain unclear; however, our results will help clarify this issue in the future.
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Affiliation(s)
- Yutaka Okagawa
- Department of Gastroenterology, Tonan Hospital, North 4, West 7, Chuo-ku, 060-0004, Sapporo, Hokkaido, Japan.
| | - Tetsuya Sumiyoshi
- Department of Gastroenterology, Tonan Hospital, North 4, West 7, Chuo-ku, 060-0004, Sapporo, Hokkaido, Japan
| | - Takayuki Imagawa
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, Hokkaido, Japan
| | - Hiroya Sakano
- Department of Gastroenterology, Japanese Red Cross Date Hospital, Date, Hokkaido, Japan
| | - Fumito Tamura
- Department of Gastroenterology, Sapporo Kiyota Hospital, Sapporo, Hokkaido, Japan
| | - Yohei Arihara
- Department of Gastroenterology, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Yusuke Kanari
- Department of Gastroenterology, Chitose City Hospital, Chitose, Hokkaido, Japan
| | - Akira Sakurada
- Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Hokkaido, Japan
| | - Shutaro Oiwa
- Department of Gastroenterology, Oji General Hospital, Tomakomai, Hokkaido, Japan
| | - Takashi Jin
- Department of Internal Medicine, Rishiri Island National Health Insurance Center Hospital, Rishiri, Hokkaido, Japan
| | - Yusuke Tomita
- Department of Gastroenterology, Tonan Hospital, North 4, West 7, Chuo-ku, 060-0004, Sapporo, Hokkaido, Japan
| | - Shinya Minami
- Department of Gastroenterology, Oji General Hospital, Tomakomai, Hokkaido, Japan
| | - Hiroyuki Hisai
- Department of Gastroenterology, Japanese Red Cross Date Hospital, Date, Hokkaido, Japan
| | - Hirohito Muramatsu
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, Hokkaido, Japan
| | - Shinichi Katsuki
- Department of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Hokkaido, Japan
| | - Masahiro Maeda
- Department of Gastroenterology, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Hitoshi Kondo
- Department of Gastroenterology, Tonan Hospital, North 4, West 7, Chuo-ku, 060-0004, Sapporo, Hokkaido, Japan
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Arai T, Kunogi T, Kinebuchi T, Nakano Y, Nishikawa K, Sugiyama H. Successful Endoscopic Removal of Anisakis Larva that Deeply Invaded the Gastric Mucosa Using Jumbo Forceps. Case Rep Gastroenterol 2023; 17:321-326. [PMID: 37946744 PMCID: PMC10631773 DOI: 10.1159/000533808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/09/2023] [Indexed: 11/12/2023] Open
Abstract
Anisakiasis is a parasitic disease caused by the ingestion of raw or uncooked seafood infected with third-stage larvae of anisakid nematodes. Generally, the larvae parasites live at the surface of the mucosa, but in this case, the larva deeply invaded its head into the gastric mucosa and was not removable with conventional biopsy forceps. In our case, we demonstrated the usefulness of jumbo forceps to remove the Anisakis larva in such a situation.
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Affiliation(s)
- Toshio Arai
- Department of Internal Medicine, Furano Kyokai Hospital, Furano, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takehito Kunogi
- Department of Gastroenterology, Genseikai Moriyama Hospital, Edogawa City, Japan
| | - Takahiro Kinebuchi
- Department of Clinical Laboratory, Furano Kyokai Hospital, Furano, Japan
| | - Yasuhiro Nakano
- Funrano Gastroenterology and Internal Medicine Clinic, Furano, Japan
| | - Koji Nishikawa
- Department of Gastroenterology, Furano Kyokai Hospital, Furano, Japan
| | - Hiromu Sugiyama
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
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Kołodziejczyk L, Szostakowska B, Sobecka E, Szczucki K, Stankiewicz K. First case of human anisakiasis in Poland. Parasitol Int 2020; 76:102073. [PMID: 32044432 DOI: 10.1016/j.parint.2020.102073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/14/2020] [Accepted: 02/07/2020] [Indexed: 02/06/2023]
Abstract
Consumption of raw or inadequately processed marine fish may result in anisakidosis - a zoonotic disease caused by larvae of the parasitic nematodes of the family Anisakidae (anisakiasis when caused by members of the genus Anisakis (Nematoda: Anisakidae)), commonly found in a variety of marine fish species all over the world. Most cases of anisakidosis have been detected in the residents of Japan and South Korea, which results from the tradition of eating raw and semi-raw fish dishes. However, the disease is now increasingly often diagnosed in other parts of the world, including Europe (mainly in Spain and Italy). In Poland, no cases of human infection with anisakid nematodes have been detected so far. In this study, we report the first case of gastric anisakiasis in Poland, in a 59-year-old female patient, after eating raw Atlantic salmon (Salmo salar). The parasite was identified as the third-stage larva of Anisakis simplex sensu stricto on the basis of morphology and molecular analysis. The larva was still alive and causing pain until it was removed, which occurred more than 5 weeks after infection. The described case prove that anisakiasis should be considered as a potential cause of gastrointestinal tract ailments following the consumption of seafood in countries where no cases of this zoonosis have been reported to date.
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Affiliation(s)
- Lidia Kołodziejczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Beata Szostakowska
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdańsk, Powstania Styczniowego 9B, 81-519 Gdynia, Poland.
| | - Ewa Sobecka
- Department of Hydrobiology, Ichthyology and Biotechnology of Breeding, West Pomeranian University of Technology, Kazimierza Królewicza 4, 71-550 Szczecin, Poland
| | - Krzysztof Szczucki
- Department of Surgery, Independent Public Healthcare Facility, M. Niedziałkowskiego 4A, 73-200 Choszczno, Poland
| | - Kamil Stankiewicz
- Department of Surgery, Independent Public Healthcare Facility, M. Niedziałkowskiego 4A, 73-200 Choszczno, Poland
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Yamamoto K, Takahashi O, Kobayashi D. Comparison of risk factors between human intestinal and gastric Anisakiasis. Parasitol Int 2019; 75:102024. [PMID: 31730806 DOI: 10.1016/j.parint.2019.102024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Little is known in the difference of host factors between intestinal and gastric anisakiasis. The aim of this study was to investigate the associated factors of intestinal anisakiasis in patient's characteristics and the subsequent variation compared to gastric anisakiasis. METHODS At St. Luke's International Hospital in Tokyo, Japan, a retrospective cohort study was conducted from April 2004 to June 2017. All adult patients who were clinically diagnosed as anisakiasis based on Computed Tomography (CT) scan or endoscopy were included, and anti-Anisakis antibodies (IgG and IgA) were measured for serological validation of anisakiasis, strengthen the diagnosis. Anisakiasis was categorized as either intestinal or gastric depending on its affected site. We compared patients' demographics, social history, and physical and laboratory findings between those with intestinal and gastric anisakiasis by bivariate analyses, followed by multivariate analyses. RESULTS A total of 302 patients were included in this study, where the mean age (SD) was 46.5 (14.4) and 66.6% were male. Ninety-two patients (30.5%) had intestinal anisakiasis. Multivariate regression revealed that patients with intestinal anisakiasis were more 45 years old or older (odds ratio (OR) 3.45, 95% confidence interval (CI): 1.53-7.69), male (OR 2.70, 95% CI: 1.20-6.25) and regular alcohol drinker. In terms of the physical and laboratory findings, patients with intestinal anisakiasis had greater heart rate (OR 2.86, 95% CI: 1.33-6.25), higher total protein (OR 2.86, 95% CI: 1.16-6.67), and higher C-reactive protein (CRP) (OR 11.1, 95% CI: 3.03-33.3). CONCLUSIONS Older males who were regular alcohol drinkers were associated with intestinal anisakiasis, and often heart rate, total protein, and CRP were elevated compared to those of patients with gastric anisakiasis.
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Affiliation(s)
- Kazuki Yamamoto
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.
| | - Osamu Takahashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.
| | - Daiki Kobayashi
- Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan; Fujita Health University, Toyoake, Japan.
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