A 46-year-old male patient presented with a three-month history of gastric fullness and abdominal distension, with no changes in intestinal transit or emission of pathological products.
She came to the emergency department with abdominal pain for 15 days.
Analytically, he had a leukocytosis of 17,800 leukocytes/μL, the rest of the laboratory tests being normal.
A computed tomography (CT) of the abdomen was performed, identifying a mass at the fat level with rareness and thickness of 41x46x60 mm, calcified material of distribution in layers, adjacent to a regional ileum without inflammatory process (posi
Given the findings, laparotomy was performed, which showed a mesenteric injury to the terminal ileum level, and when a neoplasic process was suspected, a block intestinal resection was performed together with a tumor.
Postoperative period was satisfactory and the patient was discharged on the fifth postoperative day.
The pathology report reported an ovoid neoformation of 6.5 x 4 cm of firm consistency.
Microscopic sections showed an inflammatory process that ulcerated the mucosa extending to the rest of the wall and the perinucleate fat was composed of small lymphocytes, plasma cells, polymorphonuclear cells, neutrophils and large eosinophils;
A conglomerate of necrotic eosinophilic material with calcium deposits and a peripheral palisade of epithelioid histiocytes with some multinucleated giant cells were identified in the peritoneal meso.
The adjacent lymph nodes were affected showing a reactive lymphoid follicular hyperplasia.
SAP and Ziehl techniques did not detect resistant acid bacilli.
Suggesting the morphological characteristics of the process a parasitic etiology.
Subsequently, in view of the pathological findings, a cocultivation was performed (negative for Salmonella, Shigella, Yinia, Ylobacter and direct parasitological examination negative for Salmonella, as well as direct examination for faeces).
Finally allergic rhinitis was confirmed, the RAST for Anisakis being 0.97 kU/L, so it was considered positive moderate class 2 (0.70 to 3.4 kU/L).
