Successful Conservative Management of Emphysematous Phlegmonous Gastritis: A Case Report

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.

Bibliographic Details

Main Authors:	Ferreira,Carlos Noronha, Correia,Luís, Barjas,Elídio, Serejo,Fátima, Moura,Miguel Carneiro de
Format:	Digital revista
Language:	English
Published:	Sociedade Portuguesa de Gastrenterologia 2010
Online Access:	http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-81782010000300004
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