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Small bowel strangulation caused by parasitic peritoneal strand.
Nobutaka Masui1, Noriyuki Fujima, Takeshi Hasegawa
1Department of Medicine, Sapporo Higashi-Tokushukai Hospital, Sapporo, Japan.
Pathology International
|May 18, 2006
Summary
Anisakidosis can cause strangulation ileus due to parasitic peritoneal strands. This case highlights the risk associated with consuming raw fish, leading to a rare presentation of ectopic anisakidosis.
Area of Science:
- Parasitology
- Gastroenterology
- Surgical Pathology
Background:
- Ectopic anisakidosis is a rare parasitic infection.
- Consumption of raw or undercooked fish is a known risk factor.
- Anisakis larvae can cause gastrointestinal and ectopic manifestations.
Observation:
- A 51-year-old woman presented with symptoms of small bowel obstruction.
- Surgical exploration revealed a strangulated small bowel segment caused by a peritoneal strand.
- Pathological examination of the strand identified features consistent with Anisakis larva, including granulomatous inflammation and necrosis.
Findings:
- The peritoneal strand contained a degenerate Anisakis larva (Type I), indicative of ectopic anisakidosis.
- The larva's presence triggered a significant inflammatory response, leading to granuloma formation and necrosis.
- The case demonstrates a rare cause of strangulation ileus attributed to Anisakis larva migrans.
Implications:
- This case underscores the potential for Anisakis larvae to cause severe abdominal complications beyond typical gastric or intestinal penetration.
- Early recognition and surgical intervention are crucial for managing strangulation ileus secondary to ectopic anisakidosis.
- Public health awareness regarding the risks of consuming raw fish, particularly in endemic areas, is important to prevent Anisakis infections.