Binmoeller K F, Benner K G
Department of Medicine, Oregon Health Sciences University, Portland.
Am J Gastroenterol. 1992 Apr;87(4):526-9.
We report a 72-yr-old female hospitalized for an upper gastrointestinal hemorrhage who developed emphysematous gastritis and gas in the portal vein. Endoscopy of the stomach revealed severe circumferential erythema, erosions, exudates, and friability of irregularly thickened proximal gastric folds. The patient became septic on the third day of hospitalization and deteriorated rapidly. Computerized tomographic scan of the abdomen revealed extensive collections of gas within the gastric wall and in the intrahepatic portal veins. Autopsy revealed severe atherosclerotic disease and a stenosis with thrombus at the origin of the celiac artery. Clostridium welchii was isolated in blood cultures prior to the patient's death. Postmortem review of endoscopic biopsies of the stomach revealed changes of incipient gastric infarction.
我们报告一例72岁女性因上消化道出血住院，并发气肿性胃炎及门静脉积气。胃镜检查显示胃严重环形红斑、糜烂、渗出，近端胃皱襞不规则增厚且质脆。患者在住院第三天发生脓毒症并迅速恶化。腹部计算机断层扫描显示胃壁及肝内门静脉广泛积气。尸检发现严重动脉粥样硬化疾病及腹腔动脉起始处狭窄伴血栓形成。患者死亡前血培养分离出魏氏梭菌。胃内镜活检的尸检复查显示早期胃梗死改变。
