title: Phlegmonous gastritis presenting as portal venous pneumatosis.
abstract: BACKGROUND
  Phlegmonous gastritis is a rare and highly lethal primary bacterial infection of the stomach. The pathogenesis of this disease is understood poorly and no detailed description of its associated findings on computed tomography has been reported.
  
  
  METHODS
  Case report and literature review.
  
  
  METHODS
  The authors describe an 84-year-old male with phlegmonous gastritis presenting as an abdominal catastrophe with portal venous pneumatosis observed on computed tomography.
  
  
  CONCLUSIONS
  The association of portal venous air and related computed tomographic findings suggesting compromise of the gastric wall should be regarded with suspicion, and the possibility of phlegmonous gastritis should be entertained. Broad-spectrum antibiotic coverage should be instituted. Gram stain of the tissues of the stomach wall may help direct antibiotic therapy toward streptococcal infections as opposed to polymicrobial processes.
authors.affiliation: Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: Yuen-Jong
authors.initials: YJ
authors.lastname: Liu
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Siracuse
authors.forename: Thomas
authors.initials: T
authors.lastname: Gage
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Hauser
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005743:Gastrectomy; D005756:Gastritis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011169:Portal Vein / Q000473:pathology*; D013270:Stomach / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed