Clinical Manifestation of Gastric Anisakiasis

Abstract

We diagnosed 72 patients in the Hokuriku district as having gastric anisakiasis following gastric fiberscope examination in our clinic over a 9-year period (January 1977 to December 1985). The patients were treated by removal of the larva in all cases. The clinical manifestations of gastric anisakiasis in these cases are described in this chapter. Van Thiel et al. [1] in 1960 first reported a patient suffering from acute abdominal pain caused by the Anisakis larva found in the intestine. Since then, many cases of anisakiasis have been reported. Most of the cases can be classified as the acute type on the basis of their clinical course with acute abdominal pain (acute type, fulminant form). However, in some cases, the pain is mild and lasts for a relatively long time (chronic type, mild form). There are also some cases in which patients without any severe symptoms are only later diagnosed as having gastric anisakiasis following endoscopic examination, as shown in the report of Hoshihara et al. [2]. In some cases, patients with acute abdominal pain did not undergo any endoscopic examination, and they were later diagnosed as having gastric anisakiasis as a result of endoscopie examination showing parasitic granuloma [3–6]. Even in the chronic type, close analysis of the patient’s history reveals that most patients with gastric anisakiasis experienced some of the clinical symptoms, such as mild abdominal pain. These acute and chronic manifestations will be explained separately.