A Case of Bleeding Gastric Lesion: A Diagnosis to Keep in Mind

Daniela Marra, Grazia Travaglini, Aroldo Fianchini, Cristina Marmorale


The gastric Anisakidosis is a rare parasitic disease caused by the ingestion of larvae of marine nematodes in raw or undercooked fish. The most common symptoms include nausea, diarrhea, abdominal pain and allergic reactions such as urticaria or anaphylaxis. Rare cases of chronic form may manifest as Anisakidosis gastric submucosal eosinophilic granuloma. These paintings raise considerable problems of differential diagnosis with other diseases such as gastric peptic ulcer, gastric cancer, GIST, and gastric lymphoma. We reporte a case of acute bleeding of the upper gastrointestinal tract with severe anemia and radiographic findings highly suspicious for GIST of the gastric fundus, which had been treated with emergency gastric resection. The lesion was histologically proven to be an eosinophilic granuloma containing fragments of helminths. The definitive diagnosis was supported by the finding of high levels of anti-Anisakis Antibodies (>100 kUA/L) and subsequently confirmed by history positive for ingestion of raw fish. In view of the increased habit to eat raw fish due to the spread of Eastern cultures in our country, the Anisakidosis should always taken into consideration in the differential diagnosis of gastric lesions especially in cases of reported ingestion of undercooked or raw fish before the onset of symptoms.

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