Wei Rui-Yao, Zhu Jia-Hui, Li Xiang, Wu Jian-Yong, Liu Jun-Wei
Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
World J Clin Cases. 2023 Dec 16;11(35):8357-8363. doi: 10.12998/wjcc.v11.i35.8357.
Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopathologically. Early diagnosis and treatment can only be achieved through upper gastrointestinal endoscopy after symptoms appear.
A 68-year-old woman with a history of intracranial aneurysm developed dizziness, chest tightness and unconsciousness for 2 d. Computed tomography angiography showed diffuse coronary atherosclerosis, moderate to severe stenosis in the proximal end of the left anterior descending branch, multiple calcified plaques in the proximal end of the circumflex branch and right coronary artery, and mild to moderate stenosis. The patient also developed diffuse atherosclerosis in the splenic and mesenteric arteries, with mild lumen stenosis and atherosclerosis in the abdominal aorta and its branches. Endoscopy showed submucosal congestion and damage of the entire gastric mucosa, of which the fundus and body of the stomach were most seriously affected. The mucosa was swollen, with a deep purple color, surface erosion and dark red oozing blood. Pathological examination showed bleeding and necrosis of the gastric mucosa, with residual contours of the gastric glands, consistent with ischemic gastritis.
Ischemic gastritis is a rare disease that may be difficult to diagnose as its symptoms may be similar to those of other gastrointestinal diseases. Diagnosis is usually based on endoscopic and pathological examinations, which show insufficient blood supply to the gastric mucosa leading to mucosal damage and necrosis.
缺血性胃炎是一种临床罕见疾病，死亡率高，在医学文献中报道较少，在临床和组织病理学方面认识不足。只有在症状出现后通过上消化道内镜检查才能实现早期诊断和治疗。
一名68岁有颅内动脉瘤病史的女性出现头晕、胸闷和意识丧失2天。计算机断层扫描血管造影显示弥漫性冠状动脉粥样硬化，左前降支近端中度至重度狭窄，回旋支和右冠状动脉近端多发钙化斑块，轻度至中度狭窄。患者还出现脾动脉和肠系膜动脉弥漫性动脉粥样硬化，腹主动脉及其分支轻度管腔狭窄和动脉粥样硬化。内镜检查显示整个胃黏膜黏膜下充血和损伤，其中胃底和胃体受影响最严重。黏膜肿胀，呈深紫色，表面糜烂，暗红色渗血。病理检查显示胃黏膜出血和坏死，胃腺轮廓残留，符合缺血性胃炎。
缺血性胃炎是一种罕见疾病，由于其症状可能与其他胃肠道疾病相似，可能难以诊断。诊断通常基于内镜和病理检查，显示胃黏膜血供不足导致黏膜损伤和坏死。
