Scholarlink

<p>A 66-year-old man underwent endoscopic mucosal resection (EMR) for a small foveolar-type gastric adenoma with a raspberry-like appearance in <i>Helicobacter pylori</i>-naïve gastric mucosa. The following day, he developed high fever and septic shock with hemodynamic instability without abdominal pain. Contrast-enhanced computed tomography revealed localized gastric wall thickening from the fundus to the body, consistent with phlegmonous gastritis (PG) after EMR complicated by septic shock with hemodynamic instability. He was successfully managed conservatively with meropenem. <i>Streptococcus parasanguinis</i> and <i>Streptococcus salivarius</i> were subsequently isolated from the gastric juice.</p><p>PG is a rare but potentially fatal bacterial infection of the gastric wall that progresses rapidly. High fever is the most consistent finding, whereas abdominal pain may be absent, delaying recognition. Delayed diagnosis often leads to systemic sepsis and contributes to its high mortality. The main route of infection is direct mucosal invasion, often after endoscopic procedures, and most cases develop within one day of the intervention, with surgery frequently required. When high fever develops within a few days after endoscopic intervention, PG should be considered in the differential diagnosis, even in the absence of abdominal pain, to ensure timely management.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Case report: phlegmonous gastritis after endoscopic mucosal resection for a Helicobacter pylori-naïve foveolar-type gastric adenoma with a raspberry-like appearance

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年4月1日

查看全文
  • Kenichi Kishimoto,
  • Kotaro Shibagaki,
  • Yusuke Takahashi,
  • Satoshi Kotani,
  • Mamiko Nagase,
  • Asuka Araki,
  • Norihisa Ishimura,
  • Daisuke Niino,
  • Shunji Ishihara

摘要

A 66-year-old man underwent endoscopic mucosal resection (EMR) for a small foveolar-type gastric adenoma with a raspberry-like appearance in Helicobacter pylori-naïve gastric mucosa. The following day, he developed high fever and septic shock with hemodynamic instability without abdominal pain. Contrast-enhanced computed tomography revealed localized gastric wall thickening from the fundus to the body, consistent with phlegmonous gastritis (PG) after EMR complicated by septic shock with hemodynamic instability. He was successfully managed conservatively with meropenem. Streptococcus parasanguinis and Streptococcus salivarius were subsequently isolated from the gastric juice.

PG is a rare but potentially fatal bacterial infection of the gastric wall that progresses rapidly. High fever is the most consistent finding, whereas abdominal pain may be absent, delaying recognition. Delayed diagnosis often leads to systemic sepsis and contributes to its high mortality. The main route of infection is direct mucosal invasion, often after endoscopic procedures, and most cases develop within one day of the intervention, with surgery frequently required. When high fever develops within a few days after endoscopic intervention, PG should be considered in the differential diagnosis, even in the absence of abdominal pain, to ensure timely management.