scholarly journals Combination of antibiotics, gastric lavage and nasojejunal feeding—an effective alternative for the management of acute phlegmonous gastritis: a case report

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098574
Author(s):  
Jiwei Wang ◽  
Tao Zhang ◽  
Xin Zhou ◽  
Handong Huang ◽  
Maijian Wang ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Gastric Wall ◽  
Gastric Lavage ◽  
Effective Alternative ◽  
Histological Evaluation ◽  
Early Enteral Nutrition ◽  
Comprehensive Treatment ◽  
Abdominal Symptoms ◽  
Phlegmonous Gastritis ◽  
Nasojejunal Feeding

Background Phlegmonous gastritis is a rare bacterial infection of the gastric wall, characterised by purulent inflammation of the gastric mucosa, submucosa and muscularis layers. Phlegmonous gastritis has a high mortality rate, even with correct diagnosis and antimicrobial therapy. Case presentation A 22-year-old man presented for acute epigastric pain associated with aqueous diarrhoea, vomiting and sustained fever. Abdominal computed tomography showed diffuse oedema and thickened gastric wall, increased number and size of abdominal lymph nodes and the absence of pneumoperitoneum. Fibregastroscopy revealed oedematous, ridged and thickened gastric mucosa with abundant purulent secretion, especially in the antrum, consistent with phlegmonous gastritis, which was confirmed by histological evaluation of gastric biopsies. Cultures of the tissue biopsies and purulent secretion were positive for Enterococcus cecorum. He was treated with sensitive antibiotics according to the antibiogram, and importantly, with continuous gastric lavage and individualised nutritional support therapy. He eventually recovered well and was discharged with no abdominal symptoms. Conclusions Our case indicates that early diagnosis and immediate treatment are crucial to achieve positive outcomes. The combination of sensitive antibiotics, gastric lavage and early enteral nutrition via nasojejunal feeding might be an effective alternative for the comprehensive treatment of acute phlegmonous gastritis.

scholarly journals Effects of experimental infections with larvae of Eustrongylides ignotus Jäegerskiold, 1909 and Contracaecum multipapillatum (Drasche, 1882) Baylis, 1920 in rabbits

2004 ◽  
Vol 56 (3) ◽  
pp. 325-332 ◽  
Author(s):  
L.A. Barros ◽  
R. Tortelly ◽  
R.M. Pinto ◽  
D.C. Gomes
Keyword(s):  
Gastric Mucosa ◽  
Gastric Wall ◽  
Clinical Signs ◽  
Nematode Species ◽  
Mammalian Host ◽  
Post Inoculation ◽  
Bright Field ◽  
Experimental Inoculation ◽  
Bright Field Microscopy ◽  
Eustrongylides Ignotus

Rabbits were infected per os with 10 Eustrongylides ignotus L4 and with 50 Contracaecum multipapillatum L3 per rabbit, recovered from naturally infected freshwater fishes (Hoplias malabaricus) in order to evaluate the patogenicity of these two nematode species in mammalian host. Two rabbits (20%) infected with E. ignotus died before the fourth day post-inoculation (one after 51 and the other after 78 hours). Six rabbits (60%) were inappetent until the fifth day following experimental inoculation. No clinical signs in rabbits inoculated with C. multipapillatum were observed; nevertheless, eight (80%) animals were positive for this nematode species. Rabbits inoculated with E. ignotus, had gastric congestion with hematoma of the gastric wall in 60% of the cases. Peritoneum was congested in 20% of the animals with the presence of peritoneal abscess in 10% of the cases. All inoculated animals showed hyperemia of the gastric mucosa with hemorrhagic gastritis due to infections with E. ignotus. In C. multipapillatum inoculated animals, the hyperemia was followed by disruption of the epithelial mucosa in the sites of parasite attachment. In the gastric mucosa, miscellaneous leukocitary infiltrates, with multifocal necrosis reaching the submucosa in the infections with C. multipapillatum were observed under bright field microscopy. Perforating lesions in several organs, mainly in the gastric wall, pancreas and liver, always in the presence of a mixed inflammatory process, intensely fibrous, with hemorrhage and necrosis were observed in animals infected with E. ignotus.

PA35 HISTOLOGICAL EVALUATION OF GASTRIC MUCOSA IN COELIAC DISEASE CHILDREN AND ADOLESCENTS. THE ROLE OF APCA DETECTION

2010 ◽  
Vol 42 ◽  
pp. S356
Author(s):  
R. Nenna ◽  
G. Mastrogiorgio ◽  
M. Mennini ◽  
L. Petrarca ◽  
M. Guido ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Coeliac Disease ◽  
Children And Adolescents ◽  
Histological Evaluation

scholarly journals Emphysematous Gastritis in the Setting of Chronic Abdominal Pain

2020 ◽  
Author(s):  
Aws Alameri ◽  
Alsadiq Al Hillan ◽  
Abdulrahman S. Museedi ◽  
Ahmed Oglah ◽  
Mohammed Alkhero ◽  
...  
Keyword(s):  
Septic Shock ◽  
Abdominal Pain ◽  
Gastric Wall ◽  
Chronic Abdominal Pain ◽  
Caustic Ingestion ◽  
Rare Entity ◽  
Mucosal Integrity ◽  
Abdominal Symptoms ◽  
Emphysematous Gastritis ◽  
Wall Invasion

Emphysematous gastritis is a rare but fatal variant of gastritis. It is caused by gastric wall invasion by gas-forming organisms. It follows disruption of gastric mucosal integrity by a variety of factors, most commonly caustic ingestion and alcohol abuse. Patients typically present with abdominal symptoms with features of septic shock. Emphysematous gastritis carries a high mortality rate warranting early intervention with supportive measures and broad-spectrum antibiotics. It is essential to consider this rare entity in the differential diagnosis of a patient presenting with abdominal pain as timely intervention is crucial for survival.

Observation of inadvertent tube loss in ICU: effect of nasal bridles

2019 ◽  
Vol 28 (18) ◽  
pp. 1170-1174
Author(s):  
Kaylee Allan ◽  
Stephen Taylor ◽  
Rowan Clemente ◽  
Deirdre Toher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Service Evaluation ◽  
Early Enteral Nutrition ◽  
Feeding Tubes ◽  
Nasojejunal Feeding ◽  
Review Current

Background: safe placement and securement of feeding tubes are essential to establishing early enteral nutrition. Nasogastric or nasojejunal feeding tubes are often inadvertently removed, and using a nasal bridle can reduce the number of tube replacements required. Aim: to review current nasal bridle practices on one intensive care unit. Over a 3-month period, nasal bridle use was recorded to measure unintentional tube loss and tube duration (the time a tube remained in situ). Method: an observational service evaluation. Findings: 109 patients were recruited; 205 tubes were passed and 77 bridles were inserted, with 42% (n=46) of the bridles placed on day 1. Tubes secured with tape were more likely to be dislodged than tubes secured with a bridle, P=0.0001. Duration of tubes remaining in situ was significantly longer in patients who had a bridle fitted on day 1, P=0.0001 compared with tubes secured with tape. Conclusion: securing a tube with a nasal bridle from day 1 is independently associated with reduced tube loss, increased duration of tube use, and likelihood that the tube would reach redundancy when it was no longer required.

Phlegmonous Gastritis Associated With Kaposi Sarcoma: A Case Report and Review of the Literature

2004 ◽  
Vol 128 (7) ◽  
pp. 801-803
Author(s):  
Qing Qing Yu ◽  
Amina Tariq ◽  
Stephen W. Unger ◽  
Beria Cabello-Inchausti ◽  
Morton J. Robinson
Keyword(s):  
Antibiotic Therapy ◽  
Abdominal Cavity ◽  
Gastric Wall ◽  
Kaposi Sarcoma ◽  
Partial Gastrectomy ◽  
Hiv Positive ◽  
Free Fluid ◽  
Computed Tomographic ◽  
Phlegmonous Gastritis ◽  
Group A

Abstract We report a case of phlegmonous gastritis associated with Kaposi sarcoma in a 37-year-old, human immunodeficiency virus (HIV)–positive man who presented with an acute abdomen. Computed tomographic scan revealed free fluid in the abdominal cavity and a thickened gastric wall. A partial gastrectomy was performed. The resected portion of stomach had a hemorrhagic, necrotic thickened wall and showed extensive, acute suppurative inflammation, especially in the submucosa, with focal transmural involvement. Beneath an area of healing ulceration, a focus of Kaposi sarcoma was present. Group A β-hemolytic streptococcus was grown from peritoneal fluid, and treatment with numerous antibiotics was initiated. After a difficult postoperative course that responded to 8 weeks of antibiotic therapy, the patient was medically stable and discharged from the hospital on antiretroviral therapy for HIV. Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the gastric wall. Kaposi sarcoma is one of the most common malignancies in HIV-positive patients, and gastric involvement is relatively common in those patients with systemic Kaposi sarcoma. To our knowledge, this is the first reported case of phlegmonous gastritis associated with Kaposi sarcoma, and it represents a rare survival following surgical and antibiotic therapy.

scholarly journals A Case of Phlegmonous Gastritis in a Patient with Psoriatic Arthritis on Infliximab

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Laurence De Davide ◽  
Annie Beaudoin
Keyword(s):  
Psoriatic Arthritis ◽  
Conservative Treatment ◽  
Immunosuppressive Therapy ◽  
Male Patient ◽  
High Mortality ◽  
Gastric Wall ◽  
Favourable Outcome ◽  
Pyogenic Infection ◽  
Phlegmonous Gastritis

Phlegmonous gastritis is a pyogenic infection affecting the submucosa of the gastric wall. Although rarely diagnosed, it remains a disease with high mortality. We thereby describe the case of a 42-year-old male patient known for psoriatic arthritis on Infliximab who was diagnosed with phlegmonous gastritis secondary to immunosuppressive therapy. The patient had a favourable outcome with a conservative treatment consisting of a 14-day course of broad antibiotherapy.

scholarly journals Does troncular vagotomy modify the proliferative gastric lesions induced in rats by duodenogastric reflux?

2007 ◽  
Vol 22 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Paulo Antônio Rodrigues ◽  
Shoiti Kobayasi ◽  
Maria Aparecida Marchesan Rodrigues
Keyword(s):  
Gastric Mucosa ◽  
Gastric Wall ◽  
Duodenogastric Reflux ◽  
Biological Behavior ◽  
Jejunal Loop ◽  
Antral Mucosa ◽  
Benign Lesions ◽  
Pyloric Mucosa ◽  
Male Wistar Rats ◽  
Anterior Gastric Wall

PURPOSE: to investigate if combining VT to DGR through the pylorus can modulate the biological behavior of PL induced by DGR and to verify if TV alone can induce morphologic lesions in the gastric mucosa. METHODS: 62 male Wistar rats were assigned to four groups: 1 - Control (CT) gastrotomy; 2 - Troncular Vagotomy (TV) plus gastrotomy; 3 - Duodenogastric reflux through the pylorus (R) and 4 - Troncular vagotomy plus DGR (RTV). The animals were killed at the 54 week of the experiment. DGR was obtained by anastomosing a proximal jejunal loop to the anterior gastric wall. TV was performed through isolation and division of the vagal trunks. Gastrotomy consisted of 1 cm incision at the anterior gastric wall. PL were analyzed gross and histologically in the antral mucosa, at the gastrojejunal stoma and at the squamous portion of the gastric mucosa. RESULTS: Groups R and RTV developed exophytic lesions in the antral mucosa (R=90.9%; RTV=100%) and at the gastrojejunal stoma (R=54.54%; RTV=63.63%). Histologically they consisted of proliferative benign lesions, without cellular atypias, diagnosed as adenomatous hyperplasia. Both groups exposed to DGR presented squamous hyperplasia at the squamous portion of the gastric mucosa (R= 54.5%; RTV= 45.4%). TV, alone, did not induce gross or histological alterations in the gastric mucosa. TV did note change the morphologic pattern of the proliferative lesions induced by DGR. CONCLUSIONS: DGR induces the development of PL in the pyloric mucosa and at the gastrojejunal stoma. TV does not change the morphologic pattern of the proliferative lesions induced by DGR. TV alone is not able to induce morphologic lesions in the gastric mucosa.

scholarly journals Viscous methyl cellulose solution thickens gastric mucosa and increases the number of gland mucous cells in mice

2013 ◽  
Vol 110 (7) ◽  
pp. 1195-1200 ◽  
Author(s):  
Fumiyo Takabayashi ◽  
Hirotaka Sekiguchi
Keyword(s):  
Gastric Mucosa ◽  
Oral Administration ◽  
Gastric Wall ◽  
Gastric Gland ◽  
Methyl Cellulose ◽  
Control Group ◽  
Cellulose Solution ◽  
Mucous Cells ◽  
Tissue Slices ◽  
Mucosal Thickness

We have observed a stiffening of the gastric wall in mice following oral administration of viscous methyl cellulose (MC) solution as a vehicle for food chemicals, an effect which has not previously been reported. To further investigate this effect, young male ICR mice (n 48) were divided into four groups (one control and three experimental groups) of twelve mice each. Experimental groups I, II and III were administered 0·2 ml of 0·5 % (w/v) MC viscous solution/d via a stomach tube for 2, 3 and 4 weeks, respectively. Stomachs were collected following 12 h fasting. The weight of the stomach and mucosa of seven mice per group was measured, and the mucosa was used for the measurement of 8-oxo-2′-deoxyguanosine (8-oxodG). Stomach tissue slices from the remaining five mice per group were stained with haematoxylin and eosin to measure mucosal thickness, and were immunostained with an HIK1083 antibody to determine the number of gastric gland mucous cells. The mucosal thickness of the groups administered the MC solution for 3 and 4 weeks, and the size of the HIK1083-immunostained area of the groups administered the MC solution for 2, 3 and 4 weeks were significantly increased (P< 0·01) compared with those of the control group. The amount of 8-oxodG was not significantly affected. These results indicate that oral administration of viscous MC solution leads to the thickening of the gastric mucosa, which may be related to an increase in the number of gland mucous cells.

scholarly journals Massive Gastric Hemorrhage after Indomethacin Therapy: A Rare Presentation and Critical Management in an Extremely Preterm Infant

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 545
Author(s):  
Yen-Ju Chen ◽  
Wei-Ying Chu ◽  
Wen-Hao Yu ◽  
Chau-Jing Chen ◽  
Shu-Ti Chia ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Gastric Lavage ◽  
Arterial Line ◽  
Gastric Bleeding ◽  
Rare Presentation ◽  
Gastrointestinal Complications ◽  
Extremely Preterm

Indomethacin has been widely used in preterm infants with hemodynamically significant patent ductus arteriosus (PDA). Gastrointestinal complications of indomethacin have been reported in 5% of treated neonates. However, massive gastric mucosa hemorrhage is a rarely reported complication. To the best of our knowledge, the infant in this report is the smallest reported in the literature to have undergone successful surgery for such a complication. A male preterm infant weighing 566 g was born at 252/7 weeks of gestational age without a complicated maternal history. Soon after birth, he received nasal noninvasive respiratory support and minimal feeding. PDA was observed since the first day of life (DOL), treatments were initiated on the second DOL for the hemodynamical significance, and PDA was closed after two courses of indomethacin therapy (0.2 mg/kg). At midnight on the seventh DOL, generalized pallor, bloody gastric drainage, and a distended stomach were observed. Massive gastric bleeding was suspected. He suffered from intermittent hypotension, which was corrected with blood products and fluid resuscitation under monitoring with a radial arterial line. Gastric lavage with cooling saline was performed twice but in vain. Prior to surgical consultation, intravascular volume transfusion was given twice. An exploratory laparotomy was arranged after obtaining the parents’ consent. Blood oozing from the gastric mucosa was observed through gastrostomy and was successfully stopped via epinephrine-soaked gauze compression. After the operation, his clinical course remained uneventful, and he was discharged without neurological anomaly at two-year follow-up. Physicians need to be cautious of indomethacin’s effect on platelet dysfunction in preterm infants with multiple predisposing factors. The tendency for mucosal bleeding should be continuously monitored after indomethacin therapy.

scholarly journals Endoscopic and histological evaluation of the mucous membrane of the stomach in relatives of people suffering from cancer of the stomach

2019 ◽  
Vol 16 (4) ◽  
pp. 391-403
Author(s):  
V. V. Karpenka ◽  
Ju. V. Gorgun ◽  
N. P. Mitkovskaya ◽  
V. V. Krasko
Keyword(s):  
Gastric Cancer ◽  
Gastric Mucosa ◽  
Atrophic Gastritis ◽  
Main Group ◽  
Alcoholic Beverages ◽  
Histological Evaluation ◽  
Control Group ◽  
Cancer Of The Stomach ◽  
Younger Age ◽  
H Pylori

The condition of gastric mucosa was assessed in relatives of patients with gastric cancer (RPGC). The study included 108 RPGC (main group) and 102 patients with no family history of gastric cancer who were screened for dyspepsia. All study participants were subjected to clinical examination, questioning and esophagogastroduodenoscopy (EGDS) with a biopsy, in which the gastric mucosa state was assessed according to the modified Sydney system, the OLGA and OLGIM systems, and the definition of Helicobacter pylori (H. pylori) infection. It was established that the prevalence of H. pylori infection in the main group was 58.3 % (95 % CI 48.8–67.7), in the control group – 56.0 % (95 % CI 46.1–65.6). At RPGC, atrophy of any localization (46.3 % (95 % CI 39.4–53.2) versus 26.5 % (95 % CI 20.4–32.6), respectively, was found more often than in the control group, respectively, p = 0.002), antral atrophic gastritis (41.6 % (95 % CI 34.8–48.4) versus 26.5 % (95 % CI 20.4–32.6), respectively, p = 0.020), and isolated atrophy in the stomach body (4.6 % (95 % CI 1.7–7.4) versus 0 % ( p = 0.03). In RPGC, atrophy developed at a younger age (48.0 years (95 % CI 44.0–52.0) versus 53.0 years in the control group (95 % CI 48.3–57.8) p = 0.000). There were no significant differences between the groups in the incidence of metaplasia and dysplasia. The following risk factors for development of atrophy were identified in the factor analysis: age over 6f0 years (odd ratio (OR) 53.0; 95 % CI 12.2–390.1; p < 0.001), age over 40 years (OR 4.0; 95 % CI 2.0–8.2; p < 0.001), heredity burdened by gastric cancer (OR 2.7; 95 % CI 1.4–5.7; p = 0.006) and the use of strong alcoholic beverages (OR 5.5; 95 % CI 1.6–21.6; p = 0.009). The frequency of the atrophy development of the gastric mucosa is increased in RPGC, and atrophic gastritis develops at a younger age in comparison with individuals without a burdened hereditary history. In addition to the hereditary factor, the risk of atrophy is associated with age and alcohol use.

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