Urita Y, Nishino M, Koyama H, Kondo E, Naruki Y, Otsuka S
First Department of Internal Medicine, Toho University School of Medicine, Tokyo.
Intern Med. 1997 Dec;36(12):890-3. doi: 10.2169/internalmedicine.36.890.
A case with esophageal anisakiasis accompanied by reflux esophagitis is described. A 38-year-old man visited 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 5mm long 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 raw 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.
本文描述了一例伴有反流性食管炎的食管异尖线虫病病例。一名38岁男性在食用生乌贼约7小时后，因烧心和食物通过障碍前来我院就诊。首次食管胃镜检查发现一条异尖线虫幼虫侵入鳞柱状上皮交界处。在异尖线虫幼虫附近，鳞柱状上皮交界处近端的远端食管可见白色渗出物。用镊子很容易从食管中取出一条异尖线虫幼虫。在用兰索拉唑和西沙必利治疗8周后，内镜检查发现有白色渗出性黏膜病变的反流性食管炎以及一处长度超过5mm的线状红斑区域。6个月后第三次内镜检查显示远端食管既无渗出物也无红斑。从临床病程来看，他在食用生乌贼约7小时后出现新的烧心症状，并且在异尖线虫幼虫取出3个月后白色渗出性黏膜病变和线状红斑区域并未消失。得出的结论是，异尖线虫幼虫首先进入胃，然后通过胃食管反流返回食管。
