Abstract
A case of intussusception caused by anisakiasis of the small intestine which is rare is reported.
A 35-year-old woman had an epigastric pain in the night of January 30 after she ate sliced raw mackerel on January 29, 1994. No abnormality was revealed with endoscopic examination of the stomahc at another hospital. She was seen at the hospital because of the intensified epigastric pain on February 1. Abdominal echography revealed multiple concentric rign sign, and CT visualized a ringed invagination of the small intestine. So a diagnosis of intussuscpetion of the small intestine was made. In addition, intestinal fluoroscopy revealed a shadow like claw of crab. Laparotomy was carried out, and an intussusception ranging about 5cm at a portion 80cm distant from the Treitz ligament was found out. A partial resection of the small intestine was performed. Macroscopically, larvae (and adult worms) of Anisakis were confirmed in the resected portion and a thickening of the wall at the portion was observed. Histopathological findings included presence of Anisakis, and inflammatory cell infiltration mainly into eosinophilic leukocytes to the full thickness.
It is etiologically thought that an infection by Anisakis occurred in a portion of the small intestine, that provoked the intussusception.
