Acute Superior Mesenteric Artery Embolism With Clinical Scenario Mimicking Anisakiasis.

Acute superior mesenteric artery (SMA) occlusion is a lethal but often misdiagnosed disease. A 66-year-old man presented with marked epigastric pain after eating raw fish. Emergency gastroscopy performed due to suspected anisakiasis revealed intestinal ischemia, leading to the diagnosis of SMA embolism based on the finding of newly detected atrial flutter without anticoagulation. His symptom improved after reperfusion by endovascular therapy using a self-expandable stent, and he was discharged with the ability to eat a normal diet after additional laparoscopic partial jejunectomy. In this instructive case with a clinical scenario mimicking anisakiasis, acute SMA embolism was successfully diagnosed.