JOURNAL OF JAPAN SOCIETY FOR ENDOSCOPIC SURGERY Volume 24, Issue 2 (March 2019)
Japanese

A case of small intestinal anisakiasis requiring differentiation from strangulated small bowel obstruction diagnosed by single-incision exploratory laparoscopy Keiichiro HIRATA 1 , Tasuku MATSUOKA 1 , Kento KURATA 1 1Department of Surgery, Naniwaikuno Hospital Keyword: 小腸アニサキス症 , 腹腔鏡 , 単孔式 pp.129-133
Published Date 2019/3/15
DOI https://doi.org/10.11477/mf.4426200681
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 We report a 66-year-old man who was diagnosed with small intestinal anisakiasis which was successfully identified by a single-incision exploratory laparoscopy. He was admitted to our hospital with sudden abdominal pain two days after eating raw fish. He exhibited tenderness in the umbilical region with rebound tenderness and muscular rigidity. Computer tomography (CT) demonstrated swollen partial segment of the small bowel with signs of inflammation, and intestinal dilatation with fluid collection on the oral side of the lesion. Because anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT findings, we performed an emergency exploratory laparoscopy with a single-port approach. Clear ascites was noted in the peritoneal cavity. The serous surface of the jejunum showed redness and annular edema, causing dilatation of the proximal side of the intestine. No strangulated change or volvulus was found throughout the entire small bowel. From these findings, the patient was diagnosed with small intestine anisakiasis and conservative therapy was performed, without resecting the small intestinal lesion. The abdominal symptoms were relieved immediately and the patient was discharged on the fifth hospital day. Anti-anisakiasis antibody in serum was detected and small intestinal anisakiasis was finally diagnosed. Small intestinal anisakiasis should be considered in the differential diagnosis of acute abdomen. Single-incision exploratory laparoscopy is useful as a diagnostic tool and minimally invasive treatment.


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基本情報

13446703.24.2.jpg
日本内視鏡外科学会雑誌
24巻2号 (2019年3月)
電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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