A CASE OF ANISAKIASIS OF THE COLON CAUSING INTUSSUSCEPTION

Abstract

A 71-year-old man visited another hospital because of gradually intensifying abdominal pain on February 22 which appeared in the last evening. Abdominal ultrasonography on the next day revealed target sign at the right flank. The patient was referred to the medical center with a suspicion of intussusception. On the same day, a barium enema study revealed a filling defect like crab's claw and intussusception was diagnosed. Hydrostatic pressure reduction method was tried but failed in reduction, and an emergency operation was performed on the same day. At laparotomy, intussusception ranging about 3-4cm in the right side of the transerse colon was present. Manual reduction was impossible, and a resection of the colon about 20cm in length was performed because a possibility that the intussusception might be caused by some malignant tumor could not be ruled out. The resected material showed edema and reddening on the mucosa with the width of 35mm longitudinally and over the entire circumference of the colon. On close observation, worms which seemed to be anisakis were confirmed on the surface of mucosa where inflammatory tumor was formed.