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DOI: 10.1055/s-2004-813238
© Karl Demeter Verlag im Georg Thieme Verlag KG Stuttgart · New York
Emphysematous Gastritis - Case Report and Review of the Literature
Emphysematöse Gastritis - Ein Fallbericht und Übersicht der Literatur The authors wish to thank Marijana Gajek-Marchetti, translator, from the Medical Research Department of Maribor Teaching Hospital, for her contribution in translating the manuscript.Publication History
manuscript received: 27.1.2004
manuscript accepted: 5.5.2004
Publication Date:
16 August 2004 (online)
Zusammenfassung
Die emphysematöse Gastritis ist eine seltene Form der Magenphlegmone, hervorgerufen durch die Invasion gasbildender Bakterien in die Magenwand. Dieses Einheitsbild wurde erstmals von Fränkel im Jahr 1889 beschrieben. Wir berichten über den Fall eines 58-jährigen Patienten mit Niereninsuffizienz im Endstadium, der während des letzten Jahres mittels Hämodialyse behandelt wurde. Er wurde wegen Unterbauchschmerzen aufgenommen. Das diagnostische Verfahren bestätigte eine emphysematöse Gastritis und akute Cholezystitis. Es kam zu einer akuten Bauchfellentzündung, die eine Notlaparotomie verlangte. Während des Eingriffs wurde die nekrotische Gallenblase entfernt. Der Patient starb am Tag darauf wegen mehrfachen Organversagens und septischen Schocks. Luft in der Magenwand ist ein seltener Befund mit einer breiten Differenzialdiagnose. Nach der Fachliteratur ist die emphysematöse Gastritis in der Regel eine tödliche Krankheit.
Abstract
Emphysematous gastritis is a rare form of phlegmonous gastritis caused by invasion of the stomach wall by gas-forming bacteria. This clinical entity was first described by Fraenkel in 1889. The authors report the case of a 58-year-old patient with end-stage renal failure under treatment with hemodialysis for the past year. He was admitted on account of pain in the lower abdomen. During the diagnostic procedure, emphysematous gastritis and acute cholecystitis were confirmed. An acute abdomen developed and an emergency laparotomy was performed. During the procedure, the necrotic gallbladder was removed. The patient died on the following day due to multiorgan failure and septic shock. According to the literature, emphysematous gastritis is generally a fatal disease. Air in the wall of the stomach is a rare finding with a broad differential diagnosis.
Schlüsselwörter
Emphysematöse Gastritis - Niereninsuffizienz im Endstadium - akute Cholezystitis - Notlaparotomie
Key words
Emphysematous gastritis - end-stage renal failure - cholecystitis - emergency laparotomy
References
- 1 Fraenkel E. Ueber einen Fall von Gastritis acuta emphysematosa warscheinlich mykotischen Ursprungs. Arch Pathol Anat Physiol Klin Med. 1889; 118 526-535
- 2 Moosvi A R, Saravolatz L D, Wong D H. et al . Emphysematous gastritis: case report and review. Rev Infect Dis. 1990; 12 848-855
- 3 Van Mook W NKA, Van der Geest S, Goessens M LMJ. et al . Gas within the wall of the stomach due to emphysematous gastritis: case report and review. Eur J Gastroenterol Hepatol. 2002; 14 1155-1160
- 4 Brenner C, Hamilton S. Image of the month. Gastroenterology. 2000; 118 1000-1283
- 5 Shipman P J, Drury P. Emphysematous gastritis: case report and literature review. Australasian Radiol. 2001; 45 64-66
- 6 Fidvi S A, Klein S A. Radiological case of the month - clinical quiz. Appl Radiol. 2002; 31 33-36
- 7 Wong Y Y, Chu W C. Emphysematous gastritis associated with gastric infarction in a patient with adult polycystic renal disease: CT diagnosis. Am J Radiol. 2002; 178 1291
- 8 Weens H S. Emphysematous gastritis. AJR. 1946; 55 588-593
- 9 Kussin S Z, Henry C, Navarro C. et al . Gas within the wall of the stomach: report of a case and review of the literature. Dig Dis Sci. 1982; 27 949-954
- 10 Grayson D E, Abbott R M, Levy A D. et al . Emphysematous infections of the abdomen and pelvis: a pictorial review. RadioGraphics. 2002; 22 543-561
- 11 Berry W B, Hall R A, Jordan G L Jr. Necrosis of the entire stomach secondary to ingestion of a corrosive acid. Am J Surg. 1965; 109 652-655
- 12 Clearfield H R, Shin Y oung H, Schrielman B K. Emphysematous gastritis due to lye ingestion. Am J Dig Dis. 1969; 14 195-199
- 13 McKelvie P A, Fink M A. Fatal case of emphysematous gastritis and esophagitis. Pathology. 1994; 26 490-492
- 14 Badrinath K, Jairam N, Ravi H R. et al . Gastric emphysema following drug induced gastritis. Br J Surg. 1992; 79 320
- 15 Van Allan R J, Krebs T L, Henzie G M. et al . Emphysematous gastritis in an immunocompromised host. Clin Imaging. 1995; 19 129-130
- 16 Cherney C L, Chutuape A, Fikrig M K. Fatal invasive gastric mucormycosis occurring with emphysematous gastritis: case report and literature review. Am J Gastroeneterol. 1999; 94 252-256
- 17 Van Leeuwen M L, Tjiong H L, van Blankenstein M. et al . Phlegmonous gastritis: an unusual presenting symptom of Sjogren’s syndrome. Gut. 1993; 34 1142-1144
- 18 Rowen M, Myers M, Williamson R A. Emphysematous gastritis in a leukemic child. Med Pediatr Oncol. 1976; 2 433-437
- 19 Williford M E, Foster W L Jr, Halvorsen R A. et al . Emphysematous gastritis secondary to disseminated strongyloidiasis. Gastrointest Radiol. 1982; 7 123-126
- 20 Bloodworth L L, Stevens P E, Bury R F. et al . Emphysematous gastritis after acute pancreatitis. Gut. 1987; 28 900-902
- 21 Caruana V, Swayne L C, Salaki J S. Indium-III WBC detection of emphysematous gastritis in pancreatitis. J Nucl Med. 1990; 31 112-114
- 22 Smith T J. Emphysematous gastritis associated with adenocarcinoma of the stomach. Am J Dig Dis. 1966; 11 341-345
- 23 Lagios M D, Suydam M J. Emphysematous gastritis with perforation complicating phytobezoar. Am J Dis Child. 1968; 116 202-204
- 24 Hadas-Halpren I, Hiller N, Guberman D. Emphysematous gastritis secondary to ingestion of large amount of Coca Cola. Am J Gastroenterol. 1993; 88 127-129
- 25 Binmoeller K F, Benner K J. Emphysematous gastritis secondary to gastric infarction. Am J Gastroenterol. 1992; 87 526-528
- 26 Lin C Y, Lee C S, Lin D Y. et al . Emphysematous gastritis secondary to acute gastric dilatation. J Gastroenterol Hepatol. 1995; 10 612-615
- 27 Ulloa R amirez SA, Ortiz J ustiniano VN, Soler C andelaria E. et al . Gastric emphysema simulating perforated hollow viscus: case report and review of literature. Bol Asoc Med Puerto Rico. 1997; 89 200-202
- 28 Sud A, Lehl S S, Bhasin D K. et al . Emphysematous gastritis. Am J Gastroenterol. 1996; 91 604-605
- 29 Skok P, Ceranic D, Sinkovic A. et al . Peptic ulcer hemorrhage: argon plasma coagulation versus injection sclerotherapy: a prospective, randomised, controlled study. Verdauungskrankheiten. 2001; 19 107-113
- 30 Bashour C A, Popovich M J, Irefin S A. et al . Emphysematous gastritis. Surgery. 1998; 123 716-718
- 31 Low V HS, Thompson R I. Gastric emphysema due to necrosis from massive gastric distention. Clin Imag. 1995; 19 34-36
- 32 De Lange E E, Slutsky V S, Swanson S. et al . Computed tomography of emphysematous gastritis. J Comput Assist Tomogr. 1986; 10 139-141
- 33 Williamson M R, Shah H R, Harper R R. et al . CT of emphysematous gastritis. Comput Med Imaging Graph. 1989; 13 175-177
- 34 Omojola M F, Pirani M K, Sylven M. et al . Computed tomographic evaluation of gastric emphysema - a report of three cases. Clin Radiol. 1997; 52 381-383
- 35 Weston T S. Emphysematous gastritis: Report of a case. Aust NZ J Surg. 1975; 45 261-262
- 36 Kinkhabwala M N, Conradi H, Farman J. et al . Acute emphysematous gastritis. The significance of the angiographic findings. Radiology. 1973; 109 553-554
- 37 Nemeck A A. CT of acute gastrointestinal disorders. Radiol Clin North Am. 1989; 27 773-786
- 38 Montferrante M, Shimkin P. CT diagnosis of emphysematous gastritis. Am J Radiol. 1989; 153 191-192
M.D.Ph. D. Ass. Prof. P Skok
Medical Department, Maribor Teaching Hospital
Ljubljanska 5
2000 Maribor
Slovenia
Email: Pavel.Skok@sb-mb.si