Small bowel strangulation caused by parasitic peritoneal strand
| Autor: | Noriyuki Fujima, Yozo Shimizu, Takeshi Hasegawa, Noboru Kagei, Kazuo Nagashima, Nobutaka Masui, Sanshiro Kigawa |
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| Rok vydání: | 2006 |
| Předmět: |
Abdominal pain
Pathology medicine.medical_specialty Necrosis Ileus Anisakiasis Anisakis Pathology and Forensic Medicine Ileum medicine Eosinophilia Animals Humans Leukocytosis biology business.industry Ileal Diseases Granuloma Foreign-Body General Medicine Middle Aged biology.organism_classification medicine.disease Bowel obstruction Granuloma Female medicine.symptom Peritoneum business Intestinal Obstruction |
| Zdroj: | Pathology international. 56(6) |
| ISSN: | 1320-5463 |
| Popis: | A 51-year-old woman with a history of eating raw fish over a period of 2 weeks developed a progressive abdominal pain and leukocytosis with signs of small bowel obstruction. Eosinophilia was not detected in the peripheral blood. The patient underwent surgery to clarify the possibility of ileus. Partial small bowel near the ileum was trapped by a peritoneal strand and was strangulated for approximately 30 cm in length with congestion and edema. The removal of the strand easily released the strangulation and the small bowel returned to a normal appearance. Pathologically, the strand consisted of granulomatous inflammation with a wide zone of necrosis containing a dead ghost feature of a parasite in its center. The necrosis was surrounded by palisading spindle cells with largely lymphocytic infiltration and a few eosinophils. In the parasite, there presented the polymyalian type muscle layer, ventricles and Renette cells, which suggested that the parasite is compatible with the third stage larva of Anisakis type I, leading to the diagnosis of ectopic anisakidosis. It should be noted that, on rare occasions, Anisakis larva migrans can form a peritoneal strand with a wide zone of necrosis and cause strangulation ileus, especially in populations with the habit of eating raw fish. |
| Databáze: | OpenAIRE |
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