Cic edizioni internazionali
Il Giornale di Chirurgia

Small bowel obstruction caused by Anisakis and Meckel’s diverticulum: a rare case

Clinical practice, 281 - 283
doi: 10.11138/gchir/2016.37.6.281
Tag this article
Abstract
Enhanced HTML Full text PDF
Introduction. Anisakiasis is a parasitic infection caused by the ingestion of raw fish contaminated by larval nematodes of Anisakis species. Intestinal or extraintestinal manifestations are rated to > 4% and >1% respectively.
Presentation of case. A 61-year old patient was admitted to our General Surgical and Emergency Unit because of sudden abdominal pain, vomit and constipation. He had eaten raw fish 3 days before admission. Laboratory data showed high levels of WBC and PCR. CT scanning showed “dilation of jejunum and ileum loops, thickening of the terminal ileum and cecum and signs of inflammation of the intestinal wall and mesentery”. The following emergency surgical procedure was performed: laparotomy with evidence of obstruction of the small bowels, a giant Meckel’s diverticulum, resection of terminal ileum and cecum and ileocolonic anastomosis. At the microscopic examination, the intestinal wall appeared occupied by a transmural inflammatory
infiltrate, mainly eosinophilic, edema and nematode larvae, referable to Anisakis, surrounded by necrotic-inflammatory material. Moreover, there was evidence of giant a Meckel’s diverticulum.
Discussion. Normally, enteric anisakiasis exhibits leukocytosis with eosinophilia and high CRP levels. There are cases of successful medical treatment and other cases of endoscopic treatment avoiding surgical procedure. In our case, enteric Anisakias had not been taken into consideration at the moment of the operation and only histopathology could reveal Anisakis larvae inside the intestinal wall.
Conclusion. Our surgical approach is considered in literature as the best one for this clinical presentation. Those patients need to be better studied and more attention should be paid to their history.

Vol. XXXIX (No. 3) 2018 May - June

  1. Comparison of outcomes following intersphincteric resection vs low anterior resection for low rectal cancer: a systematic review
    Ursi P., Santoro A., Gemini A., Arezzo A., Pironi D., Renzi C., Cirocchi R., Di Matteo F.M., Maturo A., D'Andrea V., Sagar J.
    doi: 10.11138/gchir/2017.39.3.123
  2. Enterocutaneous fistula treatment: case report and review of the literature
    Assenza M., Rossi D., De Gruttola I., Ballanti C.
    doi: 10.11138/gchir/2017.39.3.143
  3. 3D MRI segmentation and 3D circumferential resection margin evaluation for a standard rectal cancer assessment
    Lorenzon L., Bini F., Quatrale M., Biondi A., Persiani R., Di Pietropaolo M., Landolfi F., Iannicelli E., Marinozzi F., Balducci G., D'Ugo D.
    doi: 10.11138/gchir/2017.39.3.152
  4. Thyroid neoplasms: surgical and cyto-histopathological connections on a six year cases study
    Fontana T., Izzo M., Venturelli P., Lentini V.L., Falco N., Gulotta L., Florena A.M., Cocorullo G.
    doi: 10.11138/gchir/2017.39.3.158
  5. P-POSSUM score: a prognostic instrument for postoperative complications in Crohn’s disease
    Falco N., Fontana T., Scrivano D., Tutino R., Licari L., Raspanti C., Melfa G.I., Cocorullo G.
    doi: 10.11138/gchir/2017.39.3.166
  6. Papillary thyroid microcarcinoma in super obese patient
    Ruggiero R., Bosco A., Pirozzi R., Bondanese M.C., Gualtieri G., Docimo L.
    doi: 10.11138/gchir/2017.39.3.173
  7. Combined Littre and Richter’s femoral hernia: an extremely rare intra-operative finding
    Ioannidis A., Karanikas I., Koutserimpas C., Velimezis G.
    doi: 10.11138/gchir/2017.39.3.177
  8. Concomitant small cell carcinoma and adenocarcinoma of the gallbladder: a case report
    Tornambè A., Aiello P.S.L., Tornambè G.
    doi: 10.11138/gchir/2017.39.3.181
  9. Small bowel intussusception due to malignant melanoma: primary lesion or metastases? A case report
    De Monti M., Pacchiarini L., Cestaro G., Peloni G., Fasoli F.
    doi: 10.11138/gchir/2017.39.3.184
  10. Three-trocar laparoscopic cholecystectomy under spinal anesthesia in a patient with asthma
    Tatulli F., Delcuratolo A., Caraglia A., Notarnicola A., Carbone F.P.N., Caputi A.
    doi: 10.11138/gchir/2017.39.3.188
Last Viewed articles: la lista degli ultimi x visitati.
  1. Small bowel obstruction caused by Anisakis and Meckel’s diverticulum: a rare case
    Carbotta G., Laforgia R., Milella M., Sederino M.G., Minafra M., Fortarezza F., Piscitelli D., Palasciano N.
    doi: 10.11138/gchir/2016.37.6.281
credits