2013 Volume 46 Issue 12 Pages 894-900
A 32-year-old man was transferred to our hospital because of small intestinal obstruction. At the time of admission, blood test revealed the WBC was 12,350/μl and CRP was negative. Four days after admission, he underwent exploratory laparotomy under the diagnosis of intestinal obstruction due to an unknown cause because the symptom did not improve by conservative treatment. A nodule was found in the retroperitoneum where a chord from the nodule to the mesentery of the small intestine was strangulating one part of the small intestine. The obstruction was treated by excision of the strand and nodule. Microscopic findings of the nodule showed the necrosis and an anisakis with typical pathological findings of anisakiasis, a lateral chord, intestine and Renette cells. Although reports on anisakiasis have increased in recent years, adhesive intestinal obstruction induced by extra-gastrointestinal anisakiasis is rare. A preoperative diagnosis of this disease is difficult, however, we must be attentive to this as a possible cause of intestinal obstruction.
