Gastric Anisakiasis Research Articles

Acute gastric anisakiasis: 28 cases during the last 10 years.

Anisakiasis is a disease which occurs following eating raw fish infected with anisakis larvae. Many cases have been reported from Japan and from other countries with increasing opportunities of eating raw fish such as "sushi" and "sashimi." We have reviewed 28 patients with acute gastric anisakiasis during the last 10 years from November 1984 to October 1994. This disease has rarely been detected in persons over 60 years of age and in patients with gastric surgery. Therefore it is postulated that gastric acid secretion influences the activities of anisakis larvae. An alkaline gastric pH could interfere with the toxicity of anisakis larvae.

Gastric anisakiasis cases in Cheju-do, Korea

Human anisakiasis may occur after ingestion of raw marine fish infected with nematode larvae of Anisakidae. Anisakiasis caused by the migration of the larva into the wall of stomach, small intestine and other portion has been reported in Korea. This prospective study was made of all cases referred to parasitological laboratory in Cheju-do between June 1989 and June 1992. Gastric anisakiasis was confirmed if larvae invading the gastric wall were observed by gastrofiberscopy. One hundred and seven cases were diagnosed, most of which were in 30-49 years old. Most of the patients complained acute epigastric pain with history of eating raw marine fish. This symptom usually occurred about 12 hours to 1 day after ingestion of infected marine fish. Edema, erosion or ulcer of the mucosa and hemorrhage from the gastric wall were observed in the involved areas. Ninety larvae removed from the stomach were identified; the larva of Anisakis simplex was the most prevalent species, and the larva of Pseudoterranova decipiens was also detected. The important species of marine fish from which the patients became infected was demonstrated as yellow corvina, sea eel, ling, cuttle fish, yellowtail and others. Five species of marine fish as a possible source of infection were examined, and Anisakis simplex larvae and Pseudoterranova decipiens larvae were collected from the mackerel and rock cod. This study demonstrates that anisakiasis is recognized as a public health problem in Korea.

A case of abdominal syndrome caused by the presence of a large number of Anisakis larvae

A 58-year-old woman living in Shizuoka Prefecture, Japan, complained of severe epigastric pain and nausea about 8 h after having eaten ‘Sashimi’. A gastrocamera examination undertaken as a result of her clinical history of gastric anisakiasis indicated that a large number of worms had penetrated the posterior walls. Fifty-six larval nematodes were directly removed from the greater curvature of the stomach with a gastroendoscopic biopsy clipper, and were identified as the larvae of Anisakis simplex.

Anisakiasis of the Colon: Report of Two Cases with Emphasis on the Diagnostic and Therapeutic Value of Colonoscopy

Anisakiasis of the colon is a rare entity as compared with gastric anisakiasis, and its diagnosis is very difficult. We present here two cases--a 42-year-old woman and a 30-year-old woman--of anisakiasis of the colon treated by colonoscopic removal of the worm without surgery. The importance of colonoscopy for the diagnosis and treatment of this disease is briefly discussed.

Immunoblot analysis of serum IgG, IgA and IgE responses against larval excretory-secretory antigens of Anisakis simplex in patients with gastric anisakiasis

To increase our understanding of the immune response to Anisakis infection, antigen specific IgG, IgA and IgE responses were identified using an immunoblot technique after polyacrylamide gel electrophoresis of excretory-secretory products from the larval stage of Anisakis simplex. Nine sera were drawn from proven cases of gastric anisakiasis within 3 days after symptoms had developed. The molecular weight of the major antigenic bands were distributed between 50 kDa and 120 kDa of the antigens. In nine cases of gastric anisakiasis, three of them were positive for IgG response, five for IgE, and six for IgA, respectively. None of control sera recognized the antigenic bands in IgA and IgE responses. In contrast, two controls had IgG antibodies against 1-2 proteins in the 65-95 kDa region. The antigenicity of the excretory-secretory products was lost following treatment by 0.2% trypsin, but not by 0.2 M periodic acid. Based on the results of reactivity to lectins, antigenic bands of the ES products possessed mucin type glycoconjugate residues in their protein portion. This indicates that the humoral responses of IgA and IgE antibodies to the larval ES antigens are a more reliable index of infection than that of the IgG response.

Anisakiasis.

Anisakiasis is a zoonotic disease caused by the ingestion of larval nematodes in raw seafood dishes such as sushi, sashimi, ceviche, and pickled herring. Symptoms of anisakiasis include abdominal pain, nausea, vomiting, and diarrhea. Because symptoms are vague, this disease is often misdiagnosed as appendicitis, acute abdomen, stomach ulcers, or ileitis. Endoscopic examination with biopsy forceps has facilitated the diagnosis of gastric anisakiasis. Worms can be removed and identified, and a definitive diagnosis can be made. Patients generally recover with no further evidence of disease. Worms can become invasive, however, and migrate beyond the stomach, penetrating the intestine, omentum, liver, pancreas, and probably the lungs. Surgery is often necessary for treatment of invasive anisakiasis. With the increase in popularity of eating lightly cooked or raw fish dishes, the number of cases of anisakiasis may be expected to increase.

Nine cases of acute gastric anisakiasis

From 1983 to 1988, we treated 19 patients with acute gastritis which was highly suggestive of gastritis anisakiasis. Almost all of these patients complained of sharp, periodic, upper abdominal pains which occurred several hours after ingestion of raw fish. Among the 19 patients, 10 anisakis larvae from nine patients were successfully removed by endoscopic forceps. However, in the remaining 10 patients, who also showed the typical clinical course of anisakiasis, we could not find the anisakis larvae endoscopically. All 10 larvae were identified as stage III, anisakis type 1. The intolerable pain was relieved as soon as endoscopic removal of the larvae was accomplished in all nine patients. The purpose of this article was to report the clinical findings and emphasize the importance of early endoscopic management of acute gastric anisakiasis.

Anisakiasis.

Anisakiasis is a zoonotic disease caused by the ingestion of larval nematodes in raw seafood dishes such as sushi, sashimi, ceviche, and pickled herring. Symptoms of anisakiasis include abdominal pain, nausea, vomiting, and diarrhea. Because symptoms are vague, this disease is often misdiagnosed as appendicitis, acute abdomen, stomach ulcers, or ileitis. Endoscopic examination with biopsy forceps has facilitated the diagnosis of gastric anisakiasis. Worms can be removed and identified, and a definitive diagnosis can be made. Patients generally recover with no further evidence of disease. Worms can become invasive, however, and migrate beyond the stomach, penetrating the intestine, omentum, liver, pancreas, and probably the lungs. Surgery is often necessary for treatment of invasive anisakiasis. With the increase in popularity of eating lightly cooked or raw fish dishes, the number of cases of anisakiasis may be expected to increase.

Clinical and endoscopical features in gastric anisakiasis : Fuke H, Maegawa A, Nishida R, et al. Jpn J Acute Med 1987;11:857–861

Clinical and endoscopical features in gastric anisakiasis : Fuke H, Maegawa A, Nishida R, et al. Jpn J Acute Med 1987;11:857–861

Clinical Review of Acute Gastric Anisakiasis

7 cases of Acute Gastric Anisakiasis have been reviewed at the Department of Internal Medicine. Yeungnam University Hospital from March, 1983 to December 1986. 1. Of 7 cases, the ratio of male and female was 3:4 and the age 30s occupied most (5 cases) the 50s' followed (2 cases). 2. Chief complains were in order of epigastric pain (6 cases), vomiting (3 cases), Nause (2 cases), Ulticaria (1 case) & epigastric fulling sensation (1 case). 3. In all 7 cases, the causative fish is Astroconcer myriaster. 4. The onset of symptoms was observed within 5 to 7 hours after eating the causative raw fish. 5. Gastrofiberscopic exam was undergo within 18 hours since onset of symptoms. 6. The gastrofiberscopic findings were gastric mucosal edema and redness in all 7 cases. One case also had mucosal erosion. The involved sites of the stomach were in frequency of order, the body (5 cases), the antrum (2 cases). 7. The symptoms of the patients relieved spontaneously without medical treatment after the extraction of the larva with biopsy forcep during gastrofiberscopy. 8. In Korea, many people take raw fish and there may be many patients of Anisakiasis so if much concern and careful observation are paid to whom, with severe cramping epigastric pain after taking of raw marine fish in about 10 hours, we could find out and confirm more patients suffering from Anisakiasis by immediate endoscopic gastrofiberscopy.

Acute Gastric Anisakiasis

From 1969 to 1984, we treated 178 patients with acute gastric anisakiasis caused by gastric mucosal penetration of the Anisakis larvae. Because the larvae of Anisakis can always be observed by endoscopy and removed with biopsy forceps, early performance of endoscopy is highly recommended for patients in whom acute gastric anisakiasis is suspected and for those who have eaten raw fish within 12 hours before onset of the gastric symptoms. Endoscopic removal is essential to relieve the intolerable pain; after relief, the administration of antacids will repair the damaged gastric mucosa. Ulcer formation is rare.

Acute gastric anisakiasis. Analysis of 178 cases

From 1969 to 1984, we treated 178 patients with acute gastric anisakiasis caused by gastric mucosal penetration of the<i>Anisakis</i>larvae. Because the larvae of<i>Anisakis</i>can always be observed by endoscopy and removed with biopsy forceps, early performance of endoscopy is highly recommended for patients in whom acute gastric anisakiasis is suspected and for those who have eaten raw fish within 12 hours before onset of the gastric symptoms. Endoscopic removal is essential to relieve the intolerable pain; after relief, the administration of antacids will repair the damaged gastric mucosa. Ulcer formation is rare. (<i>JAMA</i>1985;253:1012-1013)

Radiographic study of acute gastric anisakiasis.

The radiographic findings from 226 patients with acute gastric anisakiasis are reviewed. Suggestive but indeterminate findings such as coarse and broad gastric folds caused by mucosal edema were demonstrated in 224 patients (98%). In 179 patients (88%) mucosal edema was so extensive that it occupied more than half of the entire gastric wall. The most diagnostic radiographic finding, present in 139 patients, was the appearance of a threadlike filling defect about 3 cm in length, showing an anisakis larva itself. Careful demonstration of these radiographic findings is useful for the diagnosis of acute gastric anisakiasis.

Studies on the etiologic mechanism of anisakiasis

A nationwide investigation on the incidence of anisakiasis over a period of 5 years from 1973 through to 1977 was conducted by questionaire sent to 851 main medical centers throughout Japan. The number of cases for all Japanese for a period of 5 years were 334 cases of gastric anisakiasis and 45 intestinal anisakiasis. We investigated both a random group of 3,108 inhabitants of Hokkaido and 42 anisakiasis patients using skin test, indirect hemagglutination test and measurement of serum IgE. We have demonstrated that the etiologic mechanism of acute anisakiasis involved anaphylactic reaction as well as Arthus reaction in the digestive tract.