A case of phlegmonous gastritis associated with marked gastric distension

Abstract

Phlegmonous gastritis is an acute and severe infectious disease that is occasionally fatal if the diagnosis is delayed. Alcohol consumption, an immunocompromised state (e.g., due to HIV infection, rheumatoid arthritis, diabetes mellitus, or adult T-cell lymphoma), and mucosal injury of the stomach are reported to be predisposing factors. The main treatments for phlegmonous gastritis are antibiotics administration or surgery. In this case, the patient's stomach was markedly distended due to long-lasting gastric-outlet obstruction, which is thought to be the predisposing factor for phlegmonous gastritis. We inserted a metal stent at the obstructed site palliatively due to strong refusal by the patient for surgery. The patient recovered after stenting and antibiotic therapy.

Keywords: Gastric outlet obstruction; Phlegmonous gastritis.

Fig. 1

Simple abdominal X-ray showing marked distension of the stomach.

Fig. 2

Contrast-enhanced abdominal computed tomography showing a thickened gastric wall.

Fig. 3

Upper endoscopy revealing a dark-purple-colored, thickened gastric mucosa.

Fig. 4

Upper endoscopy after recovery showing a pink-colored gastric mucosa with healing ulcers.