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NEJM：胃异尖线虫病-案例报道

2016-08-19 chenshuo 译 MedSci原创

异尖线虫胃部胸痛
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患者女性，36岁，无既往病史，近日因出现严重的胸痛和上腹痛班恶心呕吐2天余而到院就诊。

患者女性，36岁，无既往病史，近日因出现严重的胸痛和上腹痛伴恶心呕吐2天余而到院就诊。

 
据该患者称，在出现胸痛前约2小时，其曾吃过生三文鱼。

常规体格检查显示腹部中度压痛。

实验室检查，显示心肌酶水平正常。

心电图和胸部X线照片均正常。 

腹部CT检查显示胃壁弥漫性增厚。

行胃镜检查显示多异尖线虫幼虫穿透粘膜的胃食管交界处、胃底、胃体和胃窦各处部位。

最后，十一条异尖线虫幼虫被医师用内窥镜钳取出（请点击原始链接观看视频），随后患者的症状得以缓解。 

异尖线虫病是异尖线虫第三期幼虫寄生在胃肠道引起的疾病，人们通常因生食含活幼虫的海鱼而感染。

原始出处： 

Uichiro Fuchizaki, M.D., and Masahi Nishikawa, M.D. Gastric Anisakiasis

N Engl J Med 2016; 375:e11August 18, 2016

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  1. 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CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=113441, encodeId=c226113441bb, content=学习学习。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Thu Sep 08 05:38:00 CST 2016, time=2016-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111253, encodeId=b6ba111253cc, content=很好，不错，以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 10:17:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106372, encodeId=30d21063e221, content=奇怪呀！好神奇的病例。学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 16:09:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104299, encodeId=3fe710429991, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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    2016-09-23 1e10c84am36(暂无匿称)

    文章不错，继续学习

    0

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    2016-09-14 青龙偃月

    好厉害啊，希望多一些这样的病例

    0

  3. 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    2016-09-08 lhl629

    学习学习。。。

    0

  4. 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CST 2016, time=2016-09-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=113441, encodeId=c226113441bb, content=学习学习。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Thu Sep 08 05:38:00 CST 2016, time=2016-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=111253, encodeId=b6ba111253cc, content=很好，不错，以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 05 10:17:00 CST 2016, time=2016-09-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106372, encodeId=30d21063e221, content=奇怪呀！好神奇的病例。学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 16:09:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104299, encodeId=3fe710429991, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Aug 26 06:46:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103974, encodeId=cf701039e474, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 01:01:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103132, encodeId=9298103132e4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-09-05 李东泽

    很好，不错，以后会多学习

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106372, encodeId=30d21063e221, content=奇怪呀！好神奇的病例。学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 16:09:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104299, encodeId=3fe710429991, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Aug 26 06:46:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103974, encodeId=cf701039e474, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 01:01:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103132, encodeId=9298103132e4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-28 李东泽

    奇怪呀！好神奇的病例。学习了

    0

  6. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Aug 26 06:46:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103974, encodeId=cf701039e474, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 01:01:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103132, encodeId=9298103132e4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-26 李东泽

    这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106372, encodeId=30d21063e221, content=奇怪呀！好神奇的病例。学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 16:09:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104299, encodeId=3fe710429991, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 10:55:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104153, encodeId=3a971041534c, content=深度好文，赞一个！!！, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Aug 26 08:58:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104069, encodeId=001b10406968, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Aug 26 06:46:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103974, encodeId=cf701039e474, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 01:01:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103132, encodeId=9298103132e4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-26 ylzr123

    深度好文，赞一个！!！

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=106372, encodeId=30d21063e221, content=奇怪呀！好神奇的病例。学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 16:09:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104299, encodeId=3fe710429991, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Fri Aug 26 06:46:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103974, encodeId=cf701039e474, content=这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Fri Aug 26 01:01:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=103132, encodeId=9298103132e4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-26 忠诚向上

    好好学习一下

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-26 李东泽

    这篇资讯写的真好，带给我们新知识，启发新思维，不论是科研还是临床工作都有很大的帮助。。。

    0

  10. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Wed Aug 24 16:53:00 CST 2016, time=2016-08-24, status=1, ipAttribution=)]
    2016-08-24 doctorJiangchao

    继续学习

    0

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