title: [A case of acute phlegmonous gastritis causing gastroparesis and cured with medical treatment alone].
abstract: Acute phlegmonous gastritis is an uncommon disease, often fatal condition characterized by suppurative bacterial infection of the gastric wall. It has a high mortality rate mainly because the diagnosis is usually made late. Until recently, gastrectomy in combination with antibiotics was recommended. We had experienced a case of 66-year-old man presented with epigastric pain, nausea, vomiting, and hematemesis, followed by aspiration pneumonia. At upper gastrointestinal endoscopy, the gastric lumen was narrow, and the mucosa was severely inflamed, which was erythematous, swelled, and showed necrotic areas covered with purulent exudate. Klebsiella oxytoca and Acinetobacter lwoffii were isolated in the gastric tissue culture. Contrast-enhanced computerized tomography scan of abdomen demonstrated diffuse gastric wall thickening and an intramural abscess in the gastric antral wall. Although delayed gastric emptying by gastroparesis prolonged the in-hospital period, the only medical treatment with antibiotics alone successfully cured the patient without gastrectomy.
authors.affiliation: Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea.
authors.forename: Nha Young
authors.initials: NY
authors.lastname: Kim
authors.forename: Ju Sang
authors.initials: JS
authors.lastname: Park
authors.forename: Ki Jong
authors.initials: KJ
authors.lastname: Lee
authors.forename: Han Kyeol
authors.initials: HK
authors.lastname: Yun
authors.forename: Ja Seon
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000150:Acinetobacter / Q000302:isolation & purification; D000208:Acute Disease; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D005756:Gastritis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D018589:Gastroparesis / Q000175:diagnosis* / Q000382:microbiology; D005773:Gastroscopy; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D041121:Klebsiella oxytoca / Q000302:isolation & purification; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D015378:Imipenem; D002443:Ceftriaxone; D015242:Ofloxacin; D002439:Cefotaxime