A Case of Small Intestinal Intussusception caused by Anisakidosis

Yasuhiro Hibi, Jiro Ogata*, Akihiro Mimuro*, Kazunari Ito* and Yasuhiko Hakamada*

Department of Surgery, Jiseikai Hospital
Department of Surgery, Toda Central General Hospital*

Intussusceptions caused by anisakiasis of the small intestine are very rare. We report such a case. A 35-year-old man who had eaten raw squid for dinner that evening reported epigastric pain and vomiting, and was treated for acute gastroenteritis, but was diagnosed with intussusception of the small intestine when abdominal Computed tomography showed multiple concentric rings the next morning. In emergency surgery, we invaginated the jejunum from 20 cm at the portion to about 15 cm away from the Treitz ligament. After reducing the intussusception manually, we resected about 30 cm of the jejunum due to severe edema. Macroscopically, the resected mucosa was reddish and edematous, but histopathological findings showed the body of anisakis in the submucosal layer to have eosinophilic leukocyte infiltration. Anisakis stuck in the jejunum region forms eosinophilic granuloma, which causes intussusception.

Key words
adult, small intestinal intussusception, Anisakis

Reprint requests
Yasuhiro Hibi Department of Surgery, Jiseikai Hospital
3-15-2 Egota, Nakano-ku, 165-0022 JAPAN

Accepted
December 17, 2008

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