Gastric anisakiasis suspected by point-of-care ultrasound finding in the emergency department

Abstract

Background

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.

Case Presentation

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 Anisakis larvae penetrating the gastric mucosa. Following treatment, his symptoms completely resolved.

Conclusion

This case suggests that point-of-care ultrasound can be a powerful diagnostic tool when clinicians suspect gastric anisakiasis.