A 61 - year - old man was referred to our hospital with abdominal pain. Abdominal computed tomography was perfoemed and indicated thickening of the ileal wall. He often ate raw fish and he had eaten raw fish one day prior to the onset of his symptom. Based on his clinical history and these images, enteric anisakiasis was suspected. Colonoscopic examination showed an anisakis larva penetrating the mucosa with redness and enlargement of the terminal ileum. The anisakis larva was removed by colonoscopy with a forceps, and his symptohm disappeared. Some patients with ileal anisakiasis develop ileus and intestinal perforation which may require surgical treatment. It is desirable to perform extraction by colonoscopy if possible when ileal anisakiasis is suspected.
