Abstract
A 31-year-old female visited our clinic complaining of abdominal pain and nausea -17 hours after she had eaten raw mackerel. Although her blood chemistry indicated leukocytosis (10,300/μl) and increased CRP (2.0 8mg/dl), she was afebrile. She exhibited tenderness in the epigastrium and right hypogastrium. A gastroscopic examination did not reveal anything remarkable. Pelvic ascites and edematous mucosa of ileum were detected with ultrasound. A small bowel follow-through X-ray with diatrizoic acid suggested segmental dilatation and narrowing of the ileum and the thumb printing sign. We inserted a double balloon endoscope through the colon and into the ileum where we found and removed an anisakis larva using endoscopic forceps. Pelvic ascites disappeared immediately and all of her symptoms improved. To the best of our knowledge, this is the first case of an ileal anisakis larva removed with double balloon endoscopy.
