Esophageal Anisakiasis Accompanied by Reflux Esophagitis.

Abstract

A case with esophageal anisakiasis accompanied by reflux esophagitis is described. A 38-year-old manvisited our hospital with complaints of heartburn and disturbance of food passage about seven hours after eating raw cuttlefish. The first esophagogastroscopy revealed an anisakis larva invading the squamocolumnar junction. Near the anisakis larva, a whitish exudate was demonstrated in the distal esophagus just proximal to the squamocolumnar junction. An anisakis larva was easily extracted from the esophagus by forceps. Reflux esophagitis with whitish exudative mucosal lesions and an area of linear erythema more than 5mmlong were noted endoscopically 8 weeks after treatment with lansoprazole and cisapride. After six months the third endoscopic examination clarified that there was neither exudate nor erythema in the distal esophagus. Judging from the clinical course that he complained of newly experienced heartburn about seven hours after eating law cuttlefish, and that whitish exudative mucosal lesions and an area of linear erythema did not disappear at three months after extraction of the anisakis larva. It was concluded that an anisakis larva enters the stomach first and then returns to the esophagus by gastroesophageal reflux. (Internal Medicine 36: 890-893, 1997)

Efficacy of lactulose plus 13 C-acetate breath test in the diagnosis of gastrointestinal motility disorders

“…We previously reported that gastric emptying, in terms of the time of peak 13 CO 2 excretion after the administration of 13 Cacetate, correlated well with serum acetaminophen concentrations 40 min after the ingestion of test meals. 24 Watanabe et al also showed the efficacy of the time of peak 13 CO 2 excretion as a marker of gastric emptying. 25 When a minute amount of lactulose reaches the cecum, it is possible that a rise in the H 2 concentration of above 5 ppm does not occur.…”

Anisakiasis in the Upper Esophagus: A Case Report

“…The most prevalent form is gastric anisakiasis, constituting approximately 95% of all reported cases. Intestinal anisakiasis represents the majority of the remaining cases, while the ectopic subtype, also known as extragastrointestinal anisakiasis, is an exceedingly rare condition [13]; several reports exist in the English medical literature [16][17][18][19][20], but only two cases were submitted to PubMed [21,22].…”

Riesgos para la salud asociados al parasitismo del pescado por nematodos de los géneros Anisakis y Pseudoterranova/Health hazards related to occurrence of parasites of the genera Anisakis and Pseudoterranova in fish

“…En las formas invasivas, el parasitismo en el hombre acostumbra a mostrar una doble localizac16n, afecta preferentemente a la mucosa gdstrica en unos casos, mientras que en otras ocasiones colonizan mayoritariamente la mucosa intestinal. Excepcionalmente pueden localizarse tamb]6n en la porci6n distal del es6fago (Urita et al, 1997;Muguruma et al, 1999). En ambos casos, las larvas III perforan la mucosa con la ayuda de un pequeno mucr6n localizado en su extremo apical, provocando pequenas lesiones y ulceras en las cuales se fijan y nutren.…”

“…La sintomatologia o las manifestaciones clinicas son variables tanto en intensidad como en aparici6n, dependiendo fundamentalmente de la localizaci6n y del numero de nematodos presentes. En los cuadros de anisakiasis g6strica las primeras molestias pueden apreciarse transcurridas pocas horas (entre 6 y 7) tras la ingesti6n del alimento responsable, mientras que se requieren varios dias antes de observar cualquier trastorno de los parasites que afectan al tracto intestinal (Urita et al, 1997). La presencia de un reducido numero de nematodos generalmente pasa desapercibida, sin manifestaciones ni trastornos aparentes.…”

“…La administraci6n de tiabendazol con dosis de 45 mg / kg de peso vivo, repitiendo el tratamiento al cabo de 3 meses ha dado resultados positivos en algunos casos (M6]ler y Anders, 1986b). No obstante, en la mayoria de los casos se hace necesario recurrir a tratamientos quirurgicos, bien mediante endoscopia equipada con f6rceps para biopsia en los casos de infestaciones leves que afectan a la mucosa esof6gica o g6strica (Petithory et al,1986;Urita et al., 1997) o mediante laparotomia con resecci6n de la zona danada cuando se trata de una infestaci6n masiva o afecta a zonas de dificil acceso en est6mago o porciones superiores del duodeno, ileon o colon (Brier, 1992;Lopez-Velez et al, 1992).…”