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Small bowel (small intestine)

Infectious disorders

Anisakis


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 16 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Larvae of Ascarids (Anisakidae) are found in sea animals
● After ingesting contaminated raw fish or other sea food, larvae attach to mucosa of stomach or small intestine and cause ulceration, penetration or perforation


Life cycle

Case reports
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● 37 year old woman with epigastric pain two hours after ingesting fried hake and fish ova, and 200 larvae obtained by endoscopy (J Investig Allergol Clin Immunol 2010;20:437)
● 50 year old man with abdominal pain and peripheral eosinophilia after eating raw salmon from Pacific Ocean (Am J Surg Pathol 2003;27:1167)

Clinical images
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Larvae in terminal ileum


Larvae in fish


Larvae in a herring

Micro description
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● Serositis, mucosal edema, submucosal abscess with eosinophils surrounding parasite with unpaired excretory gland (renette cell), Y-shaped lateral epidermal cords, no apparent reproductive system, and a ventriculus (glandular esophagus)
● No lateral alae, no ventricular appendage, no intestinal cecum

Micro images
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Larva in submucosa with eosinophils and lymphocytes


Larva in jejunum; note its intestinal lumen (L), the large lateral chords (LC) with a butterfly-like shape and many somatic muscle cells (MC); also a marked eosinophilic infiltrate with neutrophils and lymphocytes

End of Small bowel (small intestine) > Infectious disorders > Anisakis


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