Case 25. Anisakiasis of intestine (55 y-o M)
         
    Jejunum from a post-gastrectomy patient, surgically resected for acute abdomen half day after eating Sashimi (raw fish)    
         
   
Key words : 
Anisakis simplex larva, intestinal anisakiasis, gastrectomy, spirurid nematode larva, Necator americanus    
     
 
     
A 13 mm-long white helminth is stuck in the highly edematous and hyperemic jejunum (gross findings). Anisakiasis is most commonly seen in the stomach.   Life cycle of Anisakis simplex
The third stage Anisakis larva may be parasitic to most of the sea fish and squid, eating the krill. The final host of this larval parasite is the mammal animals such as the dolphins and whales.
     
 
     
Reference case 25A
Another surgical case of intestinal anisakiasis provoking eosinophilic cellulitis (44 y-o M). The Anisakis larva is histologically characterized by a pair of clover-shaped lateral chords, eosinophilic Renett cells (exocretory organ), and the gut consisting of high columnar cells.
  Reference case 25B
Spirurid nematode larva type-X causing ileus and eosinophilic cellulitis (60 y-o F). A 100 mm-wide small nematode larva reveals a pair of swollen clover-shaped lateral chords and the gut (HE). Visceral larva migrans of this kind results from the ingestion of raw firefly squid (Watasenia scintillans) in Toyama, a zone facing the Sea of Japan, during a spring season.
     
   
     
Reference case 25C
Ankylostomiasis (40 y-o F). A 1 cm-long Necator americanus stuck in the duodenal mucosa is red-colored, because of blood sucking (endoscopic findings).