Abstract：
OBJECTIVE: The aim of this study was to retrospectively review cases of intestinal anisakiasis diagnosed by CT over a 10-year period and to evaluate imaging findings associated with the disease.
METHODS: This retrospective study included 71 patients with clinical suspicion of intestinal anisakiasis in whom an abdominopelvic computed tomography (CT) was performed at a single institution between June 2011 and December 2021. To identify the cases, we used medical term search engines and the hospital\'s radiology case database. Clinical information was gathered from the medical records. A radiologist with five years of experience reviewed and analyzed the CT images to determine the characteristic findings of intestinal anisakiasis.
RESULTS: The study included 47 confirmed cases of intestinal anisakiasis. The mean age of the patients was 52 years (range 18-87 years), being more frequent in men than women (26:21). All patients reported ingestion of raw fish, most commonly anchovies in vinegar (30/47, 63,8%). Abdominal pain was the predominant symptom, accompanied by nausea, vomiting, and occasionally fever. The most common clinical suspicions were intestinal obstruction (14/47, 29,8%) and appendicitis (10/47, 21,3%), whereas intestinal anisakiasis was suspected in only 2 cases prior to imaging. CT showed thickening of the bowel wall with submucosal edema in all patients, predominantly involving the ileum (43/47, 91,5%), usually in a relatively long segment (mean of 17,5 cm, range 10-30 cm). Simultaneous involvement of multiple bowel segments was observed in 16 cases (34%). Intestinal obstruction with dilatation of proximal loops (33/47, 70,2%), ascites (45/47, 95,7%), and mesenteric fat striation (32/47, 68,1%) were also common findings.
CONCLUSIONS: This study demonstrates the value of computed tomography in suggesting the diagnosis of intestinal anisakiasis, which often presents with nonspecific clinical manifestations. The characteristic CT findings that provide diagnostic clues are bowel wall thickening with submucosal edema, typically involving a long segment of the ileum, with signs of intestinal obstruction, ascites, and mesenteric fat striation. Simultaneous involvement of several intestinal segments (typically the gastric antrum and right colon) is an additional finding to be considered and may provide a diagnostic clue.
METHODS: This retrospective study included 71 patients with clinical suspicion of intestinal anisakiasis in whom an abdominopelvic computed tomography (CT) was performed at a single institution between June 2011 and December 2021. To identify the cases, we used medical term search engines and the hospital\'s radiology case database. Clinical information was gathered from the medical records. A radiologist with five years of experience reviewed and analyzed the CT images to determine the characteristic findings of intestinal anisakiasis.
RESULTS: The study included 47 confirmed cases of intestinal anisakiasis. The mean age of the patients was 52 years (range 18-87 years), being more frequent in men than women (26:21). All patients reported ingestion of raw fish, most commonly anchovies in vinegar (30/47, 63,8%). Abdominal pain was the predominant symptom, accompanied by nausea, vomiting, and occasionally fever. The most common clinical suspicions were intestinal obstruction (14/47, 29,8%) and appendicitis (10/47, 21,3%), whereas intestinal anisakiasis was suspected in only 2 cases prior to imaging. CT showed thickening of the bowel wall with submucosal edema in all patients, predominantly involving the ileum (43/47, 91,5%), usually in a relatively long segment (mean of 17,5 cm, range 10-30 cm). Simultaneous involvement of multiple bowel segments was observed in 16 cases (34%). Intestinal obstruction with dilatation of proximal loops (33/47, 70,2%), ascites (45/47, 95,7%), and mesenteric fat striation (32/47, 68,1%) were also common findings.
CONCLUSIONS: This study demonstrates the value of computed tomography in suggesting the diagnosis of intestinal anisakiasis, which often presents with nonspecific clinical manifestations. The characteristic CT findings that provide diagnostic clues are bowel wall thickening with submucosal edema, typically involving a long segment of the ileum, with signs of intestinal obstruction, ascites, and mesenteric fat striation. Simultaneous involvement of several intestinal segments (typically the gastric antrum and right colon) is an additional finding to be considered and may provide a diagnostic clue.
摘要：
目的：本研究的目的是回顾性回顾10年期间CT诊断的肠anisakiasis病例，并评估与该疾病相关的影像学表现。
方法：这项回顾性研究包括2011年6月至2021年12月期间在单个机构进行腹盆腔CT（CT）检查的71例临床怀疑肠肛门病的患者。为了识别案件，我们使用了医学术语搜索引擎和医院的放射学病例数据库。从医疗记录中收集临床信息。一位具有五年经验的放射科医生回顾并分析了CT图像，以确定肠anisakiasis的特征性发现。
结果：本研究纳入了47例确诊的肠anisakiasis病例。患者的平均年龄为52岁（范围18-87岁），男性比女性更频繁（26:21）。所有患者都报告摄入了生鱼，最常见的是醋中的凤尾鱼(30/47，63.8%)。腹痛是主要症状，伴有恶心,呕吐,偶尔发烧。最常见的临床怀疑是肠梗阻（14/47，29,8%）和阑尾炎（10/47，21,3%），而在影像学检查之前，仅有2例怀疑肠anisakiasis。CT显示所有患者肠壁增厚伴粘膜下水肿，主要累及回肠（43/47，91,5％），通常在相对较长的段中(平均17.5厘米，范围10-30厘米)。16例（34％）同时累及多个肠段。肠梗阻伴近端环扩张（33/47，70,2%），腹水（45/47，95,7%），肠系膜脂肪横纹(32/47,68,1%)也是常见发现。
结论：这项研究证明了计算机断层扫描在提示诊断肠anisakiasis方面的价值。通常表现为非特异性临床表现。提供诊断线索的特征性CT表现为肠壁增厚伴粘膜下水肿，通常涉及回肠的长段，有肠梗阻的迹象,腹水,和肠系膜脂肪条纹。多个肠段（通常是胃窦和右结肠）的同时受累是需要考虑的另一个发现，并可能提供诊断线索。
方法：这项回顾性研究包括2011年6月至2021年12月期间在单个机构进行腹盆腔CT（CT）检查的71例临床怀疑肠肛门病的患者。为了识别案件，我们使用了医学术语搜索引擎和医院的放射学病例数据库。从医疗记录中收集临床信息。一位具有五年经验的放射科医生回顾并分析了CT图像，以确定肠anisakiasis的特征性发现。
结果：本研究纳入了47例确诊的肠anisakiasis病例。患者的平均年龄为52岁（范围18-87岁），男性比女性更频繁（26:21）。所有患者都报告摄入了生鱼，最常见的是醋中的凤尾鱼(30/47，63.8%)。腹痛是主要症状，伴有恶心,呕吐,偶尔发烧。最常见的临床怀疑是肠梗阻（14/47，29,8%）和阑尾炎（10/47，21,3%），而在影像学检查之前，仅有2例怀疑肠anisakiasis。CT显示所有患者肠壁增厚伴粘膜下水肿，主要累及回肠（43/47，91,5％），通常在相对较长的段中(平均17.5厘米，范围10-30厘米)。16例（34％）同时累及多个肠段。肠梗阻伴近端环扩张（33/47，70,2%），腹水（45/47，95,7%），肠系膜脂肪横纹(32/47,68,1%)也是常见发现。
结论：这项研究证明了计算机断层扫描在提示诊断肠anisakiasis方面的价值。通常表现为非特异性临床表现。提供诊断线索的特征性CT表现为肠壁增厚伴粘膜下水肿，通常涉及回肠的长段，有肠梗阻的迹象,腹水,和肠系膜脂肪条纹。多个肠段（通常是胃窦和右结肠）的同时受累是需要考虑的另一个发现，并可能提供诊断线索。
