2021 Volume 63 Issue 7 Pages 1365-1370
A 69-year-old woman presented with epigastric pain and hematochezia a day after she consumed raw mackerel. Contrast-enhanced abdominal computed tomography (CT) revealed mid-transverse colonic intussusception. CT did not reveal any evidence of necrosis at the intussusception site, and we performed fluoroscopically-guided colonoscopy. We observed colo-colonic intussusception of the transverse colon, and endoscopic repositioning could not be performed. Careful inspection of the highly edematous intussuscepted mucosa revealed an Anisakis body, which was removed with forceps, assisted by colonoscopy. The patient’s symptoms improved significantly after extraction of the parasite, and CT performed two days later revealed reduction of the intussusception. Colonoscopy performed 7 days after Anisakis extraction revealed successful reduction of the intussusception with edematous and ulcerative mucosa at the hepatic flexure. Intussusception secondary to colonic anisakiasis can be successfully treated by endoscopic extraction of the Anisakis parasite, even if repositioning is difficult.
