Article ID: 2024-16
Objective: In recent years, the incidence of gastric anisakiasis has been increasing in Japan. Simultaneously, cases of asymptomatic gastric anisakiasis, which were incidentally diagnosed by esophagogastroduodenoscopy (EGD) at health checkups, have been reported. We examined the characteristics of asymptomatic gastric anisakiasis diagnosed at health checkups at our institution.
Subjects & Methods: We examined the clinical characteristics, including age, sex, subjective symptoms, endoscopic findings, of 17 cases incidentally diagnosed with gastric anisakiasis by EGD performed at health checkups at our institution from August 2012 to January 2019. We compared these cases with those of gastric anisakiasis diagnosed by emergency EGD at the outpatient clinic during the same period.
Results: During the study period, 17 cases of gastric anisakiasis were diagnosed among 34,727 subjects who underwent EGD at health checkups (0.049%). The male-to-female ratio was 14:3, and median age was 63 years. Incidence of anisakiasis was highest in winter. Most of the subjects (70.6%) had eaten mackerel, squid, or other seafood within a few days prior to examination. Typically, only one larva was found per case, with the greater curvature from the gastric angle to the body being the most common site of penetration. Endoscopic findings included redness, edema, erosion, submucosal tumor-like protrusion, and blood clots. During the same period, 34 symptomatic cases were identified, presenting a younger age, more leukocytosis, and a higher number of larvae compared to asymptomatic cases.
Conclusion: Asymptomatic gastric anisakiasis is not uncommon, and it is necessary to pay attention to medical interviews and precise endoscopic findings at the time of health checkups.
