40隻寄生をみとめた胃アニサキス症の一例

Abstract

We report a case of gastric anisakiasis infected with forty worms. A 53- year-old male under chronic hemodialysis therapy was hospitalized because of nausea, vomiting and epigastralgia. These symptoms developed about two hours after the patient had eaten Saba-sushi. He also felt an itch on his back. An endoscopic examination, performed in the morning of the next day, revealed erosive gastritis accompanied by forty larval nematodes. We made a diagnosis of gastric anisakiasis. Twenty worms were removed from the stomach by a biopsy clipper. The remaining twenty worms were left in the stomach, because the patient was not able to tolerate to a prolonged endoscopic examination. However, clinical symptoms gradually disappeared in a few days, although some itches recurred on his face, abdomen and back. The endoscopic examination, performed on the fifth hospital day, revealed almost healed gastric mucosa and four living worms in the stomach. All of the four worms were removed endoscopically. Although gastric anisakiasis is the most common parasite disease of the gastrointestinal tracts, most cases of gastric anisakiasis were infected with one or two worms. The present case of gastric anisakisiasis infected with forty worms is relatively rare.