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胃壁内脓肿一例,经内镜切开引流成功治疗。

A Case of Intramural Gastric Wall Abscess, a Rare Disease Successfully Treated with Endoscopic Incision and Drainage.

机构信息

Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.

出版信息

Gut Liver. 2023 Nov 15;17(6):949-953. doi: 10.5009/gnl220009. Epub 2023 Jan 26.

Abstract

Gastric wall abscess is a rare condition characterized by a purulent inflammatory process resulting in the formation of a pocket of pus in the stomach. As the mucosa is usually intact, it requires various tools such as endoscopic ultrasonography or computed tomography for the differential diagnosis to rule out more common subepithelial tumors. Even after the diagnosis, the treatment for gastric wall abscess was previously restricted to surgical resection in combination with antibiotics. Currently, in order to avoid unnecessary surgery, the alternative method of initial treatment with an endoscopic approach is recommended. It also helps to choose appropriate antibiotics with confirmation of the pathogen by drainage. There are few reports that describe the detailed processing of the endoscopic drainage, and there is no consensus on the treatment. The pathogens that cause gastric wall abscess are usually , , and . There is only one case reported to be caused by . This is the first report of as the pathogen of the gastric wall abscess. Here, we report a case of gastric wall abscess in a 75-year-old man, safely treated by endoscopic drainage and antibiotics, confirmed by isolating the contents of the abscess.

摘要

胃壁脓肿是一种罕见的疾病,其特征为化脓性炎症过程,导致胃内形成脓肿袋。由于黏膜通常完整,因此需要各种工具,如内镜超声或计算机断层扫描进行鉴别诊断,以排除更常见的黏膜下肿瘤。即使在诊断后,胃壁脓肿的治疗以前也仅限于手术切除结合抗生素。目前,为了避免不必要的手术,建议采用内镜治疗作为初始治疗方法。通过引流确认病原体,也有助于选择合适的抗生素。很少有报道详细描述内镜引流的处理方法,也没有关于治疗的共识。引起胃壁脓肿的病原体通常为 、 、 。只有一例报告为 引起。这是首例报道 为胃壁脓肿的病原体。在这里,我们报告了一例 75 岁男性的胃壁脓肿病例,通过内镜引流和抗生素安全治疗,通过隔离脓肿内容物得到证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f36/10651380/c5ecd8985027/gnl-17-6-949-f1.jpg

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