Laparoscopic treatment for a case of ileal anisakiasis.

Small bowel anisakiasis is a relatively uncommon disease and there is only a few report of laparoscopic treatment for patients with small bowel anisakiasis. We report a case of ileal anisakiasis successfully treated by laparoscopy-assisted partial resection of the ileum. A 39-year-old Japanese man visited our hospital with right lower quadrant pain. Ultrasonography and computed tomography revealed a moderate amount of ascites and small bowel dilation. Laparoscopy performed to diagnose causes for peritonitis and ileus revealed an area of induration, 10 cm in length, and thickening of the wall of the distal ileum. Laparoscopy-assisted partial resection of the ileum was performed. An Anisakis spp. larva was found attached to the mucosa of the specimen. The patient was discharged on day 20 after surgery. Small bowel anisakiasis is often difficult to diagnose and to distinguish from other abdominal diseases. Laparoscopic examination is useful for diagnosis and treatment of this disorder.