A 36-year-old male patient with no relevant medical or surgical history came to the emergency department complaining of epigastric colic pain irradiating to the rest of the abdomen for six hours.
There is no fever, nausea, or vomiting.
Love drunk and is unable to wind.
She was discharged after spasmolytic treatment and an absolute diet.
Five days later, the patient returned to the hospital due to persistent symptoms, hypoxia and two days before presenting an episode of liquid deposition without blood or pathological products.
After an exhaustive anamnesis, he reported having consumed vinegar boilers on the day of the onset of symptoms.
On examination, the abdomen is blunt, depressible and painful to diffuse palpation, tympanic percussion and increased peristaltic noise.
Analytically stands out the normality of all biochemical data, complete blood count (including absence of seizures) and coagulation.
An abdominal X-ray showed a dilated small bowel loops, predominantly jejunal.
The patient was admitted to the hospital and an abdominal ultrasound was performed, which revealed dilatation of the small intestine loops with conserved peristalsis and the presence of free fluid interases, suggesting a mechanical ileus of minimal pleural effusion,
Abdominal CT shows dilation of the gastric chamber with the above mentioned levels of liquids in the duodenum and jejunum, without finding any evidence of obstructive cause.
During her hospital stay, a gastroscopy showed a pattern of chronic superficial gastritis.
A Prick-test is performed to confirm suspicion by Anisakis, but it is negative.
Anisakis specific IgE has a value of 15.9 kUA/l that is considered positive.
The patient improved clinically after restarting the absolute diet and serum therapy and 48 hours later he progressed to oral diet with good tolerance.
She was discharged three days after asymptomatic admission in subsequent revisions.
