Jung Ji Han, Choi Hyun Joo, Yoo Jinyoung, Kang Seok Jin, Lee Kyo Young
Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2007 Oct;22(5):923-7. doi: 10.3346/jkms.2007.22.5.923.
Emphysematous gastritis is a rare form of phlegmonous gastritis, characterized by air in the wall of the stomach due to invasion by gas-forming microorganisms. The most commonly involved microorganisms are streptococci, Escherichia coli, Pseudomonas aeruginosa, Clostrodium perfrigens and Staphylococcus aureus. Gastrointestinal mucormycosis is another rare condition, which is most frequently occurs in the stomach. Because emphysematous gastritis associated with invasive gastric mucormycosis is an extremely rare clinical condition and both are life-threatening diseases, early precise diagnosis and early treatment should be done to avoid mortality. Herein we present an extremely rare case of emphysematous gastritis associated with invasive gastric mucormycosis. A 43-yr-old man, suffering from alcoholism and diabetes, has experienced diffuse abdominal pain for 4 days. Abdominal computed tomography scan demonstrated gas within the stomach wall. A histologic examination of the total gastrectomy specimen showed several gas-filled bubbles in the wall, along with numerous fungal hyphae throughout the necrotic stomach wall. He died of multiorgan failure secondary to disseminated mucormycosis, despite the intensive medical therapy.
气肿性胃炎是一种罕见的蜂窝织炎性胃炎,其特征是由于产气微生物入侵导致胃壁内出现气体。最常涉及的微生物是链球菌、大肠杆菌、铜绿假单胞菌、产气荚膜梭菌和金黄色葡萄球菌。胃肠道毛霉菌病是另一种罕见疾病,最常发生在胃部。由于与侵袭性胃毛霉菌病相关的气肿性胃炎是一种极其罕见的临床病症,且两者均为危及生命的疾病,因此应尽早进行精确诊断和治疗以避免死亡。在此,我们报告一例极其罕见的与侵袭性胃毛霉菌病相关的气肿性胃炎病例。一名43岁男性,患有酒精中毒和糖尿病,出现弥漫性腹痛4天。腹部计算机断层扫描显示胃壁内有气体。全胃切除标本的组织学检查显示胃壁内有多个气泡,坏死的胃壁内有大量真菌菌丝。尽管进行了强化治疗,他仍死于播散性毛霉菌病继发的多器官功能衰竭。