Successful Conservative Management of Emphysematous Phlegmonous Gastritis: A Case Report

• Autor(a) principal: Ferreira,Carlos Noronha
• Data de Publicação: 2010
• Outros Autores: Correia,Luís, Barjas,Elídio, Serejo,Fátima, Moura,Miguel Carneiro de
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-81782010000300004
• topic: phlegmonous gastritis; emphysematous gastritis

BACKGROUND: Acute phlegmonous gastritis is a suppurative bacterial infection of the stomach first described by Curveilhier in 1820. The two variants which have been described are the emphysematous and the necrotizing variant. CASE REPORT: A 30 year old male presented with vomiting and diarrhea over 24 hours. Laboratory tests revealed leukocytosis, neutrophilia and raised C reactive Protein (CRP) levels. The abdominal CT scan showed a diffusely thickened stomach wall with intramural gas as well as in the peripheral intra-hepatic vessels. There was complete resolution of the emphysematous gastritis changes on empirical broad spectrum antibiotic therapy for 10 days with resolution of the emphysematous gastritis changes; oral diet was started. An exhaustive investigation for a possible etiological factor of emphysematous gastritis was inconclusive. The patient was dis­charged on the 11th day. An abdominal CT scan and upper GI endoscopy repeated after discharge were normal. CONCLUSIONS: This report describes the successful management of a patient with the emphysematous variant of phlegmonous gastritis with broad spectrum antibiotic treatment. We review the pathogenesis, clinical manifestations and management of this rare, often fatal pathology.