Kitai Yuya, Sato Ryota, Inoue Tetsuya
Department of Emergency Medicine Nerima Hikarigaoka Hospital Tokyo Japan.
Department of Critical Care Medicine Respiratory Institute, Cleveland Clinic Cleveland Ohio USA.
Acute Med Surg. 2025 Jul 11;12(1):e70080. doi: 10.1002/ams2.70080. eCollection 2025 Jan-Dec.
The diagnosis of gastric anisakiasis is typically confirmed by detecting larvae during upper gastrointestinal endoscopy. Therefore, it is important to raise clinical suspicion to prompt this procedure. While abdominal computed tomography is often performed for this purpose, the utility of ultrasound as a workup for gastric anisakiasis is not well established.
A 40-year-old male with a past medical history significant for IgA vasculitis visited the emergency department with acute onset epigastric pain. The patient had sushi containing horse mackerel, mackerel, and sardines the night before admission. Point-of-care ultrasound revealed the thickened gastric wall, which enabled us to suspect gastric anisakiasis, prompting an emergent upper gastrointestinal endoscopy. An emergency upper gastrointestinal endoscopy revealed the presence of three larvae penetrating the gastric mucosa. Following treatment, his symptoms completely resolved.
This case suggests that point-of-care ultrasound can be a powerful diagnostic tool when clinicians suspect gastric anisakiasis.
胃异尖线虫病的诊断通常通过上消化道内镜检查发现幼虫来确诊。因此，提高临床怀疑度以促使进行该检查很重要。虽然腹部计算机断层扫描常为此目的而进行，但超声作为胃异尖线虫病检查方法的效用尚未得到充分证实。
一名有IgA血管炎病史的40岁男性因急性上腹部疼痛就诊于急诊科。患者在入院前一晚食用了含有竹荚鱼、鲭鱼和沙丁鱼的寿司。床旁超声显示胃壁增厚，这使我们怀疑胃异尖线虫病，促使紧急进行上消化道内镜检查。紧急上消化道内镜检查发现有三条幼虫穿透胃黏膜。治疗后，他的症状完全缓解。
该病例表明，当临床医生怀疑胃异尖线虫病时，床旁超声可以成为一种有力的诊断工具。
