INTRODUCTION:

Anisakidosis, human infection with nematodes of the family Anisakidae, is caused most commonly by Anisakis simplex. Acquired by the consumption of raw or undercooked marine fish or squid, anisakidosis occurs where such dietary customs are practiced, including Japan, the coastal regions of Europe and the United States. rupture of the spleen is a relatively common complication of trauma and many systemic disorders affecting the reticuloendothelial system, including infections and neoplasias. A rare subtype of rupture occurring Spontaneously and arising from a normal spleen has been recognized as a distinct clinicopathologic entity. Herein we discuss the case of a woman who presented to our institution with appendicitis secondary to Anisakis and spontaneous spleen rupture.

CASE PRESENTATION:

We report the case of a 53-year-old Caucasian woman who presented with hemorrhagic shock and abdominal pain and was subsequently found to have spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. She underwent open surgical resection of the splenic rupture and the appendicitis without any significant postoperative complications. Histopathologic examination revealed appendicitis secondary to Anisakis simplex and splenic rupture of undetermined etiology.

CONCLUSIONS:

To the best of our knowledge, this report is the first of a woman with the diagnosis of spontaneous spleen rupture and appendicitis secondary to Anisakis simplex. Digestive anisakiasis may present as an acute abdomen. Emergency physicians should know and consider this diagnosis in patients with ileitis or colitis, especially if an antecedent of raw or undercooked fish ingestion is present. Spontaneous rupture of the spleen is an extremely rare event. Increased awareness of this condition will enhance early diagnosis and effective treatment. Further research is required to identify the possible risk factors associated with spontaneous rupture of the spleen.

Related Articles
Review Anisakidosis: Perils of the deep.
Clin Infect Dis. 2010
Review Anisakidosis: Perils of the deep.
Hochberg NS, Hamer DH. Clin Infect Dis. 2010 Oct 1; 51(7):806-12.
[Anisakiasis: an infestation to be known by surgeons].
Ann Chir. 2005
[Anisakiasis: an infestation to be known by surgeons].
Ortega-Deballon P, Carabias-Hernández A, Martín-Blázquez A, Garaulet P, Benoit L, Kretz B, Limones-Esteban M, Favre JP. Ann Chir. 2005 Jul-Aug; 130(6-7):407-10. Epub 2005 Apr 13.
Cough and spontaneous rupture of a normal spleen.
Chest. 2005
Cough and spontaneous rupture of a normal spleen.
Toubia NT, Tawk MM, Potts RM, Kinasewitz GT. Chest. 2005 Sep; 128(3):1884-6.
Review [Gastrointestinal anisakiasis. Study of a series of 25 patients].
Gastroenterol Hepatol. 2003
Review [Gastrointestinal anisakiasis. Study of a series of 25 patients].
Repiso Ortega A, Alcántara Torres M, González de Frutos C, de Artaza Varasa T, Rodríguez Merlo R, Valle Muñoz J, Martínez Potenciano JL. Gastroenterol Hepatol. 2003 Jun-Jul; 26(6):341-6.
Review [Allergy to Anisakis simplex].
An Sist Sanit Navar. 2003
Review [Allergy to Anisakis simplex].
Gómez B, Lasa E, Arroabarren E, Garrido S, Anda M, Tabar AI. An Sist Sanit Navar. 2003; 26 Suppl 2:25-30.

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