A Case of Acute Phlegmonous Gastritis Diagnosed with Endoscopic Submucosal Biopsy and Bacterial Culture and Improved by Antibiotics Treatment

Abstract

Phlegmonous gastritis is a rare disease of acute suppurative inflammation in the stomach wall. It is rapidly progressive and potentially fatal. Its mortality rate remains very high because the clinical diagnosis is often delayed. Many patients with phlegmonous gastritis undergo surgery. We present the case of 63-year-old woman with epigastric pain, fever, nausea and vomiting. The presumed diagnosis of acute phlegmonous gastritis was made by esophagogastroduodenoscopy, abdominal computed tomography, endoscopic ultrasonography and deep submucosal biopsy assisted with hook knife. Acinetobacter baumannii was cultured in the aspiration from the stomach. We treated the patient with antibiotics alone. Early recognition of phlegmonous gastritis by endoscopic biopsies and bacteriological study may improve the prognosis of these patient. 입원일 시행한 상부위장관내시경에서 위에 전반적인 부종이 있으면서 내강이 좁아져 보였으나 점막은 정상이었고, 위 출구 폐쇄 소견은 보이지 않았다 (Fig. 1). 복부 CT에서 위 체부에서 전정부에 걸쳐 미만성으로 저밀도의 위벽 부종이 관찰되었다