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Phlegmonous gastritis presenting as portal venous pneumatosis

Yuen-Jong Liu1, Jeffrey J Siracuse, Thomas Gage

  • 1Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.

Surgical Infections
|April 3, 2013
PubMed
Abstract

Insights

Phlegmonous gastritis, a rare bacterial stomach infection, can present with portal venous pneumatosis on CT scans. Early recognition of these CT findings is crucial for prompt treatment and improved patient outcomes.

Area of Science:

  • Gastroenterology
  • Radiology
  • Infectious Diseases

Background:

  • Phlegmonous gastritis is a rare, severe bacterial infection of the stomach with poorly understood pathogenesis.
  • Computed tomography (CT) findings associated with this condition are not well-documented.

Observation:

  • A case report details an 84-year-old male with phlegmonous gastritis.
  • The patient presented with an abdominal catastrophe.
  • CT imaging revealed portal venous pneumatosis.

Findings:

  • Portal venous air on CT scans, especially with signs of gastric wall compromise, is a critical indicator.
  • This presentation suggests a potential diagnosis of phlegmonous gastritis.

Implications:

  • Prompt recognition of CT findings suggestive of gastric wall compromise and portal venous air is vital.
  • Broad-spectrum antibiotic therapy should be initiated immediately.
  • Gram staining of stomach tissue can guide targeted antibiotic selection, differentiating between streptococcal and polymicrobial infections.

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