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Acute phlegmonous gastritis complicated by delayed perforation
Sun Young Min1, Yong Ho Kim1, Won Seo Park1
1Sun Young Min, Yong Ho Kim, Won Seo Park, Department of Surgery, Kyung Hee University School of Medicine, Seoul 130-701, South Korea.
World Journal of Gastroenterology
|April 4, 2014
Summary
This case study details a rare instance of acute phlegmonous gastritis (PG) that led to delayed gastric perforation. Prompt surgical intervention and subsequent gastrectomy were crucial for patient recovery.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Infectious Diseases
Background:
- Acute phlegmonous gastritis (PG) is a rare, severe form of gastritis characterized by diffuse gastric wall thickening and submucosal edema.
- Prompt diagnosis and management are critical due to the potential for rapid deterioration and complications such as perforation.
Observation:
- A 51-year-old woman presented with septic shock and abdominal pain, initially diagnosed with phlegmonous gastritis without clear perforation on CT.
- Exploratory laparotomy revealed suppurative peritonitis with Streptococcus pyogenes, but no initial perforation. Conservative management was initiated.
Findings:
- The patient developed delayed gastric perforation and suspected submucosal dissection, necessitating a second operation.
- Pathological examination confirmed multifocal ulceration and necrosis from mucosa to serosa with perforation.
Implications:
- This case highlights the challenges in diagnosing and managing phlegmonous gastritis, especially when perforation is delayed or not immediately apparent.
- Aggressive surgical management, including total gastrectomy, may be required for complex cases with delayed perforation and extensive gastric damage.
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