Korean J Gastroenterol.  2011 Jul;58(1):38-41. 10.4166/kjg.2011.58.1.38.

A Case of Emphysematous Gastritis in a Patient with End-stage Renal Disease

• Ko GJ
• Park KS
• Park TW
• Woo MY
• Han KJ
• Lee SC
• Cho JH

• KMID: 1792813
• DOI: http://doi.org/10.4166/kjg.2011.58.1.38

Abstract

Emphysematous gastritis is a rare infection of the stomach wall with high mortality rate. It is caused by gas forming organisms and may arise by local spread through the mucosa or hematogenous dissemination from distant focus. Clinical manifestation includes acute abdomen with systemic toxicity, and diagnosis is based on radiologic demonstration of gas within the gastric wall. Treatment should be aimed to cover gram-negative organisms and anaerobes using wide-spectrum intravenous antibiotics, and sometimes surgical management may be needed in order to enhance survival. Herein, we report a case of emphysematous gastritis in a patient with end stage renal disease on hemodialysis.

Keyword

Emphysematous gastritis; End-stage renal disease; Hemodialysis

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Emphysema
Female
Gastritis/complications/*diagnosis/radiography
Gastroscopy
Humans
Kidney Failure, Chronic/complications/*diagnosis
Klebsiella pneumoniae/isolation & purification
Middle Aged
Renal Dialysis
Sputum/microbiology
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Abdominal x-ray and CT scan findings. (A) Gas was noted in the wall of the dilated stomach. (B, C) The wall of the stomach had irregular mottled gas (arrow).

• 

  Fig. 2. Endoscopic findings. (A) The gastric mucosa of antrum had inflammation and covered with gastritis and dirty discharges. (B, C) No evidence of ulcer and necrosis at the fundus and body of the stomach was noted.

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  Fig. 3. Abdominal x-ray and CT scan findings (follow up). (A) The stomach gas was decreased. (B, C) The gastric wall became not remarkable.

Reference

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