Intestinal localization of anisakiasis manifested as acute abdomen
Intestinal localization of anisakiasis manifested as acute abdomen
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DOI：
10.1046/j.1469-0691.2003.00660.x
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发表时间：
2003-07-01
影响因子：
14.2
通讯作者：
Balbiano, R
中科院分区：
文献类型：
--
作者：
Caramello, P;Vitali, A;Balbiano, R
异尖线虫病的病理学主要由两种机制引起：过敏反应（从孤立性荨麻疹和血管性水肿到与胃肠道症状或“胃过敏性异尖线虫病”相关的危及生命的过敏性休克），以及由于肠壁侵入、嗜酸性肉芽肿发展或穿孔（胃或肠异尖线虫病）引起的直接组织损伤。异尖症是一种被误诊和低估的急腹症原因：大多数患者接受剖腹手术，几乎没有病例在手术前被诊断出来。在某些情况下，诊断是在其他病理检查过程中偶然获得的。我们报告一个因回肠末端受累而引起急腹症的病例。切除节段的显微镜检查显示存在与异尖线虫属幼虫一致的蠕虫切片。记录生鱼摄入史。阐明了组织病理学特征。对诊断器械（特别是成像和血清学）、临床方面和治疗方面的文献进行了简短但最新的综述。
Anisakis pathology is due mainly to two mechanisms: allergic reactions (from isolated urticaria and angioedema to life-threatening anaphylactic shock associated with gastrointestinal symptoms or 'gastroallergic anisakiasis'), and direct tissue damage, due to invasion of the gut wall, development of eosinophilic granuloma, or perforation (gastric or intestinal anisakiasis). Anisakiasis is a misdiagnosed and underestimated cause of acute abdomen: most patients undergo laparotomy, and virtually no cases are diagnosed before surgery. In some cases, diagnosis is obtained accidentally during other pathologic investigations. We report a case of acute abdomen due to terminal ileum involvement. Microscopic examination of the resected segment showed the presence of helminthic sections consistent with larvae of Anisakis spp. A history of raw fish ingestion was recorded. Histopathologic features are illustrated. A short but up-to-date review of the literature on diagnostic devices (particularly imaging and serology), clinical aspects and therapy is presented.