PDF(Pubmed)
Abstract：
Anisakiosis, also known as Anisakis larvae infestation, is an increasing parasitic infestation due to the worldwide spread of raw fish and shellfish consumption habits. We present a rare presentation of intestinal intussusception as a preoperative diagnosis and noticed it postoperatively due to Anisakis larvae. A 43-year-old man presented to the emergency department with abdominal pain around the umbilicus and vomiting for several hours. On physical examination at presentation, he had tenderness in the lower abdomen. His radiological studies showed a right-sided pseudo-kidney sign and ileo-colonic intussusception on ultrasound echography. His computed tomography images added findings of submucosal edema and wall thickening in the terminal ileum, swollen regional lymph nodes, and ascites. An urgent laparotomy was performed for ileo-colonic intussusception of an unknown cause. During the laparotomy, the ileocecal intussusception was manually reduced after dissecting the adhesion due to the previous appendectomy, and a partial ileotomy was undertaken using the Endo-GIA automatic anastomosis device. At the resected ileal wall surface, the presence of Anisakis larvae was noticed, and anisakidosis was diagnosed. The dietary history taken post-operatively revealed that he had eaten salmon, bonito, and squid sashimi four days prior to his emergency department visit. His postoperative course was uneventful, and he was discharged from the hospital on the fifth day postoperatively. Anisakiosis must be in the differential diagnosis of intussusception, and eating history seems like a cue to diagnose, and it might be meaningful to clinicians.
摘要：
错开,也被称为异语幼虫侵染，由于生鱼和贝类的消费习惯在全球范围内传播，寄生虫感染越来越多。我们提出了一种罕见的肠套叠表现为术前诊断，并在术后由于Anisakis幼虫而注意到。一名43岁的男子因肚脐周围腹痛并呕吐了几个小时而被送往急诊科。关于演示时的身体检查，他的下腹部有压痛。他的放射学研究显示，在超声回波描记术上有右侧假肾征和回肠结肠肠套叠。他的计算机断层扫描图像增加了回肠末端粘膜下水肿和壁增厚的发现，局部淋巴结肿大，和腹水。对不明原因的回肠结肠肠套叠进行了紧急剖腹手术。在剖腹手术中,由于先前的阑尾切除术，在解剖粘连后手动减少了回盲肠肠套叠，使用Endo-GIA自动吻合装置进行部分回肠切开术。在切除的回肠壁表面，有人注意到异语幼虫的存在，并诊断为anisakidosis.手术后的饮食史显示他吃过鲑鱼，bonito,和鱿鱼生鱼片在他去急诊室前四天.他的术后进展顺利，术后第五天出院。异位症必须在肠套叠的鉴别诊断中，进食史似乎是诊断的线索，这对临床医生来说可能是有意义的。
