case_images: PMC10631773_01
case_images: Abdominal CT image of A. simplex. Axial (a) and sagittal (b) views of computed tomography images show fat stranding around the cardiac and fundic muscle lesions of the stomach.
case_images: crg-2023-0017-0001-533808_F01.jpg
case_images: PMC10631773_01_crg-2023-0017-0001-533808_F01.jpg
case_images: F1
case_images: On arrival at our hospital, the patient first underwent computed tomography, which revealed fat stranding around the stomach but without ascites (Fig. 1a, b).
case_images: Endoscopic image of the Anisakis simplex larvae. a Endoscopic image of the stomach displaying the larvae with white light imaging. There was no part of the head or body to hold and pull out with conventional biopsy forceps. b After supplying sufficient air, a better field of vision was achieved. c, d Radial Jaw 4 cold polypectomy forceps (Boston Scientific Japan), i.e., "jumbo forceps," hold the mucosa covering the larvae and pulled out the larvae as a whole. e Bleeding was observed at the site of the larvae's invading area after the procedure. f The absence of remnants of the larvae in the stomach was verified, and the procedure was concluded.
case_images: crg-2023-0017-0001-533808_F02.jpg
case_images: PMC10631773_01_crg-2023-0017-0001-533808_F02.jpg
case_images: F2
case_images: There was no portion of the head or body to hold and pull out with a conventional biopsy forceps (Fig. 2a). After supplying sufficient air to keep a clear field of vision (Fig. 2b), we used a radial Jaw 4 cold polypectomy forceps (Boston Scientific Japan), i.e., a "jumbo forceps" to hold the mucosa and submucosa including the head and body of the larva and pulled out the larva as a whole (Fig. 2c, d). Bleeding was observed at the site of the larva's invasion after the procedure (Fig. 2e) but it stopped spontaneously. The absence of remnants of the larva in the stomach was verified, and the procedure was concluded (Fig. 2f).
case_images: Morphological image of A. simplex. a ~15 mm white worms are consistent with A. simplex larvae. b The morphological examination with a magnification power of 40 revealed the head portion of the larvae, anterior, and a boring tooth (T), and the entire larvae was covered with a rigid cuticle, consistent with A. simplex in the third-stage.
case_images: crg-2023-0017-0001-533808_F03.jpg
case_images: PMC10631773_01_crg-2023-0017-0001-533808_F03.jpg
case_images: F3
case_images: Morphological microscopic examination revealed that all the larvae were in the third stage of A. simplex (Fig. 3a, b).