腹部超音波検査を契機に発見された胃蜂窩織炎の1 例

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タイトル別名
  • The Abdominal Ultrasonographic Appearance of Acute Phlegmonous Gastritis
  • 症例 腹部超音波検査を契機に発見された胃蜂窩織炎の1例
  • ショウレイ フクブ チョウオンパ ケンサ オ ケイキ ニ ハッケン サレタ イ ホウカシキエン ノ 1レイ

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抄録

Phlegmonous gastritis (PG) is a nonspecific suppurative inflammation disease arising from the submucosal layer, and extending to the full thickness of the stomach. We herein report on a case of acute PG which was diagnosed with abdominal ultrasonography. A 64-year-old man presented at a hospital after having recently undergone pacemaker implantation for the treatment of complete atrioventricular block. He was admitted as an emergency due to a fever of 39°C. He showed anorexia, epigastralgia, vomiting of coffee-ground emesis on the second hospital day, and abdominal ultrasonography (AUS) performed on the third hospital day showed the disappearance of the normal laminated structure and hypoechoic thickening of the stomach walls. Upper gastrointestinal endoscopy revealed significant hyperplasia of the stomach walls, an erythrogenic mucosa, and poor extension. On the fourth hospital day, computed tomography revealed concentric thickening of the stomach walls. Streptococcus pyogenes was cultured from his blood sample. Based on those findings, the patient was diagnosed as having acute phlegmonous gastritis. His clinical symptoms improved and the abnormal ultrasonographic examination findings thereafter returned to normal following the administration of antibiotics. PG should therefore be included in the differential diagnosis when encountering patients with acute abdomen. We experienced a rare case of acute phlegmonous gastritis and AUS was useful for making an early diagnosis.

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 90 (2), 113-119, 2016

    一般社団法人 日本感染症学会

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