Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.
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Phlegmonous gastritis after biloma drainage: A case report and review of the literature Kai-Chun Yang, Hsin-Yu Kuo, Jui-Wen Kang World Journal of Clinical Cases.2022; 10(33): 12430. CrossRef
Sang Hun Ko, M.D., Gye Sung Lee, M.D.*, Jae I Ko, M.D., Hyng Sik Yun, M.D., Sung Keun Kim, M.D., Sung Ho Kim, M.D., Chan Woo Park, M.D. and Gwan Woo Nam, M.D.*
Korean J Gastrointest Endosc 2011;42(2):105-108. Published online February 28, 2011
Gastric wall abscess is a one form of phlegmonous gastritis and there are scare reports on this. Gastric wall abscess is a purulent inflammatory disease and it is commonly caused by a focal injury to the gastric mucosa such as a penetrating trauma from an ingested foreign body or an endoscopic biopsy where by bacterial infection occurs throughout all the layers of the gastric wall. With symptoms such as abdominal pain and fever, making the diagnosis after an operation was possible in the past, but it has recently become possible to make the diagnosis before the operation via esophagogastroduodenoscopy, endoscopic ultrasonography and/or abdominal computed tomography. We recently experienced a case of gastric wall abscess that was associated with a foreign body (presumably a fish bone) in a healthy middle aged woman. By performing generalized esophagogastroduodenoscopy and abdominal computed tomography at a primary medical institution, we made an early diagnosis and treated the patient. Herein, we report on this case and we review the relevant literature. (Korean J Gastrointest Endosc 2011;42:105-108)
Acute phlegmonous gastritis is a rare disorder in which bacterial infection occurs in the gastric wall. Gastrectomy involving the affected area has been thought to be an effective form of treatment. The mortality rate remains extremely high despite therapy with antibiotics. The authors report a case of a 59-year-old man who had severe abdominal pain with signs of peritonitis. Endoscopy showed edematous and thickened mucosal fold with narrow lumen and yellow, whitish exudate-like materials on mucosal surface in the whole stomach. Gastric juice culture revealed the growth of Enterococcus faecalis. Contrast-enhanced CT scan of abdomen showed diffuse extensive mural thickening with hypodense area from the fundus to the antrum. The lumen was narrowed, but there was no gastric outlet obstruction. There was marked thickening of gastric wall (submucosal layer) on EUS examination. Through early diagnosis without laparotomy, the patient was successfully treated with antibiotics alone without complication. (Korean J Gastrointest Endosc 2005;31:4448)
Jin Hong Park, M.D.*, Hyong Wook Kim, M.D., Won Il Park, M.D., Jong Yun Cheong, M.D., Dong Hyun Lee, M.D., Jeong Heo, M.D., Gwang Ha Kim, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D. and Ung Suk Yang, M.D.
Korean J Gastrointest Endosc 2004;29(6):509-513. Published online December 30, 2004
Gastric wall abscess is a form of phlegmonous gastritis and has been very rarely reported. The pathogenesis of gastric wall abscess is thought to involve a focal injury to the gastric mucosa such as a penetrating trauma from an ingested foreign body or an endoscopic biopsy, where by bacterial infection occurs. Gastritis cystica profunda is a rare disease in which hyperplasia of mature glandular epithelium extends into the tissues beneath the submucosa. It shows multiple small cysts in the mucosa and submucosa of the stomach. To our knowledge, the association of gastric wall abscess with gastritis cystica profunda has never been reported yet. We, recently, experienced a case of gastric wall abcess associated with gastritis cystica profunda. Herein, we report it with a brief review with literatures. (Korean J Gastrointest Endosc 2004;29:509513)
Phlegmonous gastritis is a rare disorder caused by suppurative bacterial infection of the gastric wall. The mortality rate remains extremely high and the gastrectomy has been thought to be an effective form of treatment. We report a case of acute phlegmonous gastritis developed in a patient with advanced alcoholic liver cirrhosis, and recovered with early endoscopic diagnosis and antibiotics alone. (Korean J Gastrointest Endosc 2001;23:225-229)`
We had experienced 2 cases of acute phlegmonous gastritis confirmed by endoscopy, microbiological study and surgical pathologic findings. The first was a 61- year-old female who had been diagnosed as the communicating hydrocephalus and the other was a healthy 60-year-old female. Enterococcus fecalis & Klebsiella pneumoniae, Enterococcus fecalis & E.coli were cultured from the gastric tissue and juice obtained by endoscopy in each patient. In both patients, endoscopic findings showed numerous large ulcers and edema with necrotic material and exudate over the whole stomach. Operation findings were markedly edematous and overall ulcerative mucosa in one patient, and hyperemic outlet stricture in the other. Pathologic findings were acute necrotizing inflammation, involving the mucosa and submucosal layer, consistent with acute phlegmonous gastritis. After operation and antibiotics therapy, the patients were rapidly improved. We reported 2 cases of acute phlegmonous gastritis with the review of literature.