Abstract

FERREIRA, Carlos Noronha et al. Successful Conservative Management of Emphysematous Phlegmonous Gastritis: A Case Report. J Port Gastrenterol. [online]. 2010, vol.17, n.3, pp.112-115. ISSN 0872-8178.

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.

Keywords : phlegmonous gastritis; emphysematous gastritis.

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