Introduction 

-Anisakiasis is a gastrointestinal parasitic disease caused by the larvae of the nematode, Anisakis simplex

-Transmission is due to ingestion of infective larvae from saltwater fish or squid that humans eat raw or undercooked sushi or sashimi or ceviche 

-it is most common in Japan

-Adult worms live in whales and dolphins 

Symptoms & Signs 

Acute infection can resemble appendicitis, and chronic infection can resemble gastrointestinal cancer

Severe epigastric or abdominal pain, nausea, vomiting, urticaria, angioedema, anaphylaxis 

Diagnosis 

Clinical: Acute abdomen after ingestion of raw fish 

Endoscopy: Direct visualization of larvae 

Biopsy: Eosinophilic granuloma with embedded larvae 

Treatment 

-No medical treatment is available 

-Surgical or endoscopic removal by extraction of the larvae