Necrotizing gastritis and phlegmonous gastritis--are they separate entities?

Phlegmonous gastritis, although a rare condition, is a submucosal bacterial infection strictly confined to the stomach with characteristic macroscopic and histological findings. A case of necrotizing gastritis with perforation is presented, and another similar case is reviewed, in which the gross and microscopic features are considerably different from those ascribed to classical phlegmonous gastritis. There was no evidence of an infectious aetiology in either case, and the predominant feature was necrosis. It is proposed that this variant may represent a separate disease entity of unknown aetiology. A combination of early radical gastric resection and vigorous antibiotic therapy appears to be the treatment of choice in both classical phlegmonous gastritis and necrotizing gastritis.