Korean Journal of Gastrointestinal Endoscopy 1999;19(3): 445-448.
대량 토혈을 초래한 급성 아니사키스증 1 예 ( A Case of Acute Gastric Anisakiasis Causing Massive Hematemesis )
박철영, 장영운, 김효종, 강선우, 황일섭, 김경진, 동석호, 김병호, 이정일, 장린 (Chul Young Park, Young Woon Chang, Hyo Jong Kim, Sun Woo Kang, Il Seop Hwang, Kyeong Jin Kim, Seok Ho Dong, Byung Ho Kim, Joung Il Lee and Rin Chang)
Abstract
Acute gastric anisakiasis is caused by gastric mucosal penetration from an Anisakis larvae. It occurs with those who ingest raw or inadequately cooked saltwater fish or squid containing anisakis. The clinical symptoms are severe abdominal pain, nausea, vomiting, diarrhea, and so on. A case of acute gastric Anisakiasis with massive hematemesis was presented. Initial endoscopic examination revealed an edematous or raised erosive lesion with a small blood clot-covered vessel in the fundus which was thought to be a stigmata of recent bleeding. The lesion was treated with an epinephrine-hypertonic saline injection, electrocoagulation, and an ethanol injection. A follow-up gastroscopy revealed an artificial coagulation-induced ulcer at the previous bleeding site. At the ulcer margin, a whitish linear worm was found with half of its body penetrating the gastric mucosa. The worm was removed using biopsy forceps and the patient was subsequently placed on a soft diet. The next day however, hematemesis recurred. Gastroscopic band ligation of the vessel was performed with a cessation of bleeding. Three weeks later, a gastroscopy determined that the ulcer had completely healed. (Korean J Gastrointest Endosc 19: 445∼448, 1999)
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