PHLEGMONOUS GASTRITIS: CASE REPORT AND LITERATURE REVIEW

Aims We present a case of phlegmonous gastritis (PG).

Methods Female, 50 y.o. admitted on the 12th day from symptoms onset with suspected gastric cancer. Upon presentation she had no complaints but a history of abdominal pain, nausea, diarrhea, subfebrile temperature for 3 days which subsided with ceftriaxone prescribed for suspected gastroenteritis. Medical history is significant for arthrosis and COVID-19. She is taking aspirin and NSAIDs. Physical examination revealed mild epigastric tenderness without guarding, Bp – 150/90 mm Hg, heart rate – 78 bpm, body temperature – 37,2℃, CRP – 47,9 mg/l, Leu – 18,5 g/L, ESR – 37 mm/h. Test for syphilis was negative.She was treated with levofloxacin and metronidazole, discharged on day 15.

Results In 2013 a review of 45 PG cases was published. We performed a Pubmed search from 2013 through 09.2021 and found 45 case reports of phlegmonous gastritis, published in English (ours included).

Among 45 patients 27 (60%) were treated conservatively, 18 (40%) – operatively. The most common preexisting condition for PG was diabetes – 10(22%) and neoplasia – 10(22%), no risk factors were found in 8(18%) cases. Succumbed to the disease 6 patients resulting in mortality rate of 13,3%. PG is usually caused by a bacterial infection, the most common pathogen found in gastric content was Streptococcus – in 18 (40%), in particular Streptococcus pyogenes – 11 (24%), in 9 (20%) more than one infectious agent was discovered.

Conclusions Exact pathogen was not identified, but clinical course, endoscopic and morphological findings are consistent with phlegmonous gastritis.

Publication History

Article published online:
14 April 2022