A 30-year-old woman visited our hospital with complaints of abdominal pain, diarrhea and hematochezia in August, 1998. She often had raw fishes. Colonoscopic examination showed aphthas in the terminal ileum and she was diagnosed as aphthoid ileitis and treated by mesalazine. Her symptoms improved and colonoscopic examination showed improvement of aphthas in July, 1999. However, she again visited our hospital with complains of same symptoms in July, 2000. Colonoscopic examination showed a vivid anisakis larva penetrating the mucosa with redness and erosions in the terminal ileum. The symptoms disappeared after removal of it by colonoscopy with forceps. Relationship between aphthoid ileitis and intestinal anisakiasis is not clear. There has been only two cases of anisakiasis in the terminal ileum removed by colonoscopy including our case. It is important that anisakiasis-suspected case should undergo not only upper gastrointestinal endoscopy but also colonoscopy with precise observation of terminal ileum.
