Anisakiasis of the Terminal Ileum Removed by Colonoscopy

A 35-year-old Japanese man with no significant medical history presented to the emergency department complaining of abdominal pain, nausea, and vomiting 35 h after ingesting raw horse mackerel, sardines, and tuna. Computed tomography of the abdomen with intravenous contrast revealed significant thickening of the terminal ileum with mild proximal dilatation and moderate ascites. On colonoscopy, an actively moving anisakis larva was discovered in the terminal ileum. The larva was removed with endoscopic forceps. The patient’s symptoms resolved quickly following the procedure.