Woe sushi- gastric anisakiasis: LANCET case report
A 40-year-old man presented to the emergency department with acute upper abdominal pain 8 h after ingestion of sushi. During physical examination, he was found to have tenderness in the epigastric region. Abdominal CT showed diffuse thickening of the wall of the gastric body with surrounding fat stranding.

Emergency gastroscopy identified a 15 mm long larva of the nematode Anisakis simplex penetrating the inflamed body of the stomach. Disinfestation rapidly resolved the patient's symptoms.

Anisakiasis is a gastrointestinal infection caused in human beings by nematode larvae belonging to the family Anisakidae. The disease is caused by Anisakis spp and Pseudoterranova decipiens, which are present in both raw fish and raw squid. When the host animal dies, the larvae migrate from the viscera to the muscle.

Human infestation results from accidental ingestion of the larvae. Sources of human infections differ between countries. The larvae penetrate the gastrointestinal mucosa—leading to an inflammatory response with a generalised immunoglobulin E (IgE)—mediated allergic reaction—and this results in an ulcer, an eosinophilic granuloma, or even gastrointestinal perforation.

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