A Case of Gastric Anisakiasis Preoperatively Suspected to be Gastric Cancer

Hiroshi Maeno, Mitsunori Yasue, Hiroshi Kojima, Takashi Hirai, Junichi Sakamoto, Kenzo Yasui, Yoshitaka Yamamura, Tomoyuki Kato, Tsuyoshi Kito, Seiichi Miyaishi, Hiroaki Nakazato

Department of gastroenterological Surgery, Aichi Cancer Center Hospital

We report a case of gastric anisakiasis with a very peculiar finding. A 66-year-old man complained of abdominal pain, vomiting and high fever on Aug. 27, 1989. The next day, he was admitted to another hospital with suspected acute abdomen. Gastrofiberscopy, transendoscopic biopsy and CT were performed and gastric cancer and peritonitis carcinomatosa were diagnosed. After transfer to our hospital gastrofiberscopy was performed, but this time the biopsy was negative. We carried out a laparotomy suspecting Borrmann type 4 gastric cancer. However, we could not find any cancer cells in the resected specimen. A perforation site was found at the greater curvature, and there was an inflammatory granuloma just outside the gastric wall. An ulcer scar was found at the lesser curvature with a foreign body in it, which was suspected to be an Anisakis larva. Perforation and ulceration of the stomach caused by anisakiasis is very rarely reported in Japan. Furthermore, we had diagnosed gasric cancer by the preoperative endoscopic biopsy, but no evidence of cancer cells was found in the resected specimen.

Key words
perforation of the stomach caused by anisakiasis, gastric ulcer caused by anisakiasis

Reprint requests
Hiroshi Maeno Department of Surgery, Sapporo Tokusyukai Hospital
18-4-10 Sakaedori, Shiroishiku, Sapporo, 003 JAPAN

Accepted
November 19, 1990

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