Müller Tobias, Gmür Emanuel
Department of Surgery, GZO Spital Wetzikon, Wetzikon, CHE.
Department of Surgery, Bauchzentrum Rapperswil, Rapperswil, CHE.
Cureus. 2024 Nov 19;16(11):e73972. doi: 10.7759/cureus.73972. eCollection 2024 Nov.
Phlegmonous gastritis is a rare, suppurative bacterial infection of the gastric wall and one of the rarest complications after upper gastrointestinal endoscopy. The pathogenesis is not fully clear, but multiple risk factors have been described in literature as mucosal injury and achlorhydria. We report a case of a 76-year-old male with vomiting and epigastric pain, two days after an upper endoscopy, who presented in septic shock. The diagnostics with computed tomography showed diffuse thickening of the gastric wall, and the differential diagnosis of phlegmonous gastritis was made. Subsequently, he developed abdominal compartment syndrome and clinically deteriorated, necessitating open partial gastric resection. This case of a rare complication after upper gastrointestinal endoscopy with a potentially fatal outcome illustrates septic shock and abdominal compartment syndrome as severe complications. In this case, a combination of early antibiotic treatment and calculated surgical interventions showed a favorable outcome. Only a limited number of cases of phlegmonous gastritis after endoscopy have been published, and to the best of our knowledge, this is the second case of phlegmonous gastritis with subsequent abdominal compartment syndrome as a complication.
蜂窝织炎性胃炎是一种罕见的胃壁化脓性细菌感染，也是上消化道内镜检查后最罕见的并发症之一。其发病机制尚不完全清楚，但文献中已描述了多种危险因素，如黏膜损伤和胃酸缺乏。我们报告一例76岁男性，在上消化道内镜检查两天后出现呕吐和上腹部疼痛，表现为感染性休克。计算机断层扫描诊断显示胃壁弥漫性增厚，诊断为蜂窝织炎性胃炎。随后，他出现了腹腔间隔室综合征，临床病情恶化，需要进行开放性部分胃切除术。这例上消化道内镜检查后罕见并发症且具有潜在致命后果的病例说明了感染性休克和腹腔间隔室综合征是严重并发症。在该病例中，早期抗生素治疗和精心安排的手术干预相结合取得了良好效果。内镜检查后蜂窝织炎性胃炎的病例报道有限，据我们所知，这是第二例并发腹腔间隔室综合征的蜂窝织炎性胃炎病例。
