Abstract
A 24-year-old woman was admitted to this institution for right lower abdominal pain that had begun 2 weeks earlier. Physical examination showed localized and rebound tenderness in the right lower abdomen, and abdominal CT scan showed a mass in the ascending colon. Ultrasound reveled an edematous appendix with a hypoechoic mass suggestive of acute appendicitis. The patient underwent emergency explorative laparoscopic surgery. Intraoperative findings revealed an inflammatory granuloma 3 cm in diameter in the upper ascending colon. The granuloma and appendix were resected. Pathologic study discovered filamentous material in the granuloma that was identified as an anisakiasis body. Our presumptive diagnosis was anisakiasis with intraperitoneal granuloma. Upon re-evaluation of the ultrasound study, we found that the ultrasonographic images closely resembled the cross section of the specimen. This finding suggests the possibility of using ultrasound in the early diagnosis of anisakiasis granuloma. Laparoscopic surgery proved effective.
