scholarly journals Postmortem Diagnosis of Gastric Ulcer Perforation and Peritonitis with Sarcina Ventriculi: A Case Report

2019 ◽  
Vol 24 (1) ◽  
pp. 80-82
Author(s):  
Aytül Buğra ◽  
Taner Daş ◽  
Neval Elgörmüş ◽  
Gizem Ayaz
Keyword(s):  
Gastric Ulcer ◽  
Delayed Gastric Emptying ◽  
Gastric Perforation ◽  
Histopathological Examination ◽  
Case Reports ◽  
Postmortem Diagnosis ◽  
Sarcina Ventriculi ◽  
Ulcer Perforation ◽  
Emphysematous Gastritis ◽  
Life Threatening

Sarcina ventriculi is a gram-positive anaerobic coccus with characteristic tetrad morphology. Sarcina ventriculiis identified by light microscopy with features of basophilic staining, cuboidal shape, tetrad morphology, and refractile nature. There have been very few case reports of Sarcina ventriculi reported in the literature. We present a case of a 53-year-old male, with gastric ulcer perforation where peritonitis was incidentally found to harbor Sarcina ventriculi in postmortem histopathological examination. Most of the cases exhibit abdominal pain, nausea, vomiting and delayed gastric emptying. It has also fatal life-threatening complications, such as gastric perforation and emphysematous gastritis. The histopathological examination has a key role for identification of the bacteria. The pathologist must always keep it in mind these bacteria as a cause of gastric ulcer perforation in the differential diagnosis. We want to present a case of a 53-year-old male gastric ulcer perforation who was found dead in his bed.

Sarcina ventriculi: Review of the Literature

2016 ◽  
Vol 140 (12) ◽  
pp. 1441-1445 ◽  
Author(s):  
Mohamed Rizwan Haroon Al Rasheed ◽  
Carmencita G. Senseng
Keyword(s):  
Cell Walls ◽  
Delayed Gastric Emptying ◽  
Gastric Perforation ◽  
Adult Women ◽  
Review Of The Literature ◽  
Sarcina Ventriculi ◽  
Gastric Adenocarcinomas ◽  
Emphysematous Gastritis ◽  
Gastric Biopsies ◽  
Ancillary Studies

Sarcina ventriculi is an increasingly common gram-positive coccus, recognized in gastric biopsies, particularly of patients with delayed gastric emptying. It occurs most commonly in adult women and can be identified easily by its characteristic morphologic features, such as basophilic staining, cuboid shape, tetrad arrangement, red blood cell–sized packets, flattened cell walls, and refractile nature on light microscopy. Although the pathogenesis of the organism is debated, it has been implicated in cases of gastric perforation, emphysematous gastritis, and peritonitis as well as occurring in the background of gastric adenocarcinomas. This review of the literature discusses the clinical features, endoscopy findings, histopathology, ancillary studies, microbiology, pathogenesis, differential diagnosis, treatment, and prognosis of this bacterium based on 19 published cases.

scholarly journals Fatal Outcome of Emphysematous Gastritis due to Sarcina ventriculi Infection

2021 ◽  
pp. 933-938
Author(s):  
Anita Savić Vuković ◽  
Nives Jonjić ◽  
Ana Bosak Veršić ◽  
Dražen Kovač ◽  
Marko Radman
Keyword(s):  
Clinical Presentation ◽  
Histopathological Examination ◽  
Incidental Finding ◽  
Ductus Arteriosus ◽  
Fatal Outcome ◽  
Sarcina Ventriculi ◽  
Asymptomatic Patients ◽  
Emphysematous Gastritis ◽  
Life Threatening

<i>Sarcina ventriculi</i> is an increasingly common bacterium with a variable pathogenic role. It is often an incidental finding in asymptomatic patients but can also lead to life-threatening conditions, such as gastric perforation and emphysematous gastritis. We report a case of a 14-year-old boy with fatal emphysematous gastritis caused by <i>S. ventriculi</i>, who presented with abdominal pain and vomiting. His medical history included infantile left hemiparesis and operation of patent ductus arteriosus. Emergency surgery was scheduled due to the extremely dilated stomach and gastric pneumatosis, and a total gastrectomy was performed. On the third postoperative day, he suddenly dies, and the diagnosis was confirmed postmortem. This case is an opportunity to review the clinical presentation of emphysematous gastritis and to point out the role of the histopathological examination for the identification of the bacteria.

scholarly journals Sarcina ventriculi: A Rare Case of Life-Threatening Perforated Gastric Ulcer and Review of Literature

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Qing Wei ◽  
Sixto Leal ◽  
Morad Qarmali ◽  
Charles Mel Wilcox ◽  
Chirag Patel ◽  
...  
Keyword(s):  
Gastric Perforation ◽  
Gastrointestinal Surgery ◽  
Outlet Obstruction ◽  
Gastric Surgery ◽  
Gastric Ulcers ◽  
Resected Stomach ◽  
Sarcina Ventriculi ◽  
Emphysematous Gastritis ◽  
Life Threatening ◽  
History Of

Sarcina ventriculi is a gram-positive anaerobic bacterium reported rarely in patients with a history of gastrointestinal surgery and delayed gastric emptying. Sarcina has been implicated in the development of gastric ulcers, emphysematous gastritis, and gastric perforation. So far, less than 30 cases of Sarcina isolated from gastric specimens have been reported, including 3 cases associated with life-threatening illness: emphysematous gastritis and gastric perforation. Herein, we report a case of a 58-yearold woman with history of gastric surgery who presented for evaluation of persistent gastric pain and incurable ulcer. She underwent total gastrectomy, and the resected stomach demonstrated a perforated ulcer with the presence of Sarcina microorganisms. We also report a second case of a 56-year-old woman with history of NSAID use who presented with gastric outlet obstruction. The gastric biopsy identifi ed concurrent Helicobacter pylori and Sarcina. Given Sarcina‘s association with emphysematous gastritis and gastric perforation, its identifi cation on gastric biopsies should be clearly stated in pathology reports and, depending on the clinical scenario, prompt clinicians to add adjunctive antimicrobials to anti-ulcer therapeutic regimens.

scholarly journals Emphysematous Gastritis Associated with Sarcina ventriculi

2019 ◽  
Vol 13 (1) ◽  
pp. 207-213 ◽  
Author(s):  
Kevin Singh
Keyword(s):  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Clinical Presentation ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Sarcina Ventriculi ◽  
Emphysematous Gastritis ◽  
Gastrointestinal Emergency

Emphysematous gastritis is a rare and lethal gastrointestinal emergency if not promptly identified and managed. In rare cases, emphysematous gastritis is associated with Sarcina ventriculi infection, usually in patients with delayed gastric emptying. Here we report a lethal case of S. ventriculi-associated emphysematous gastritis in the absence of delayed gastric emptying in which the diagnosis was confirmed postmortem. This case provides an opportunity to review the clinical presentation, pathophysiology, and management of emphysematous gastritis so that the condition can be promptly diagnosed and managed to prevent significant morbidity and mortality.

Sarcina Organisms in the Upper Gastrointestinal Tract: A Report of 3 Cases With Varying Presentations

2019 ◽  
Vol 28 (2) ◽  
pp. 206-209
Author(s):  
Robert Propst ◽  
Laura Denham ◽  
Jeremy K. Deisch ◽  
Tejinder Kalra ◽  
Salman Zaheer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Gastric Emptying ◽  
Delayed Gastric Emptying ◽  
Gastric Perforation ◽  
Upper Gastrointestinal Tract ◽  
Histopathologic Examination ◽  
Clinical Presentations ◽  
Emphysematous Gastritis ◽  
Upper Gastrointestinal ◽  
Gram Positive Cocci

Sarcina species are anaerobic gram-positive cocci rarely seen in the upper gastrointestinal tract and associated with delayed gastric emptying. We present 3 cases of Sarcina infection with varying clinical presentations including the first reported case of Sarcina in a patient with eosinophilic esophagitis. Although the pathogenesis of Sarcina is unclear, awareness of the bacteria is important as they can usually only be detected on histopathologic examination of upper gastrointestinal biopsies. Treatment in symptomatic patients may prevent severe complications such as emphysematous gastritis and gastric perforation.

scholarly journals A simple nomogram for early postoperative risk prediction of clinically relevant pancreatic fistula after pancreatoduodenectomy

2021 ◽  
Author(s):  
K. C. Honselmann ◽  
C. Antoine ◽  
L. Frohneberg ◽  
S. Deichmann ◽  
L. Bolm ◽  
...  
Keyword(s):  
Delayed Gastric Emptying ◽  
Model Building ◽  
Pancreatic Head ◽  
Operation Time ◽  
Early Postoperative Period ◽  
Serum Lipase ◽  
Internal Validation ◽  
Model Method ◽  
Postoperative Risk ◽  
Life Threatening

Abstract Purpose Postoperative pancreatic fistulae (POPF) present a serious and life-threatening complication after pancreatic head resections (PD). Therefore, reliable risk stratification to identify those at risk is urgently needed. The aim of this study was to identify postoperative laboratory parameters for the prediction of POPF in the early postoperative period. Methods One hundred eighty-two patients who underwent PD from 2012 until 2017 were retrospectively analyzed. Multivariate logistic regression was performed using the GLM (general linear model) method for model building. Two nomograms were created based on the GLM models of postoperative day one and postoperative day one to five. A cohort of 48 patients operated between 2018 and 2019 served as internal validation. Results Clinically relevant pancreatic fistulae (CR-POPF) were present in 16% (n = 29) of patients. Patients with CR-POPF experienced significantly more insufficiencies of gastroenterostomies, delayed gastric emptying, and more extraluminal bleeding than patients without CR-POPF. Multivariate analysis revealed multiple postoperative predictive models, the best one including ASA, main pancreatic duct diameter, operation time, and serum lipase as well as leucocytes on day one. This model was able to predict CR-POPF with an accuracy of 90% and an AUC of 0.903. Two nomograms were created for easier use. Conclusion Clinically relevant fistula can be predicted using simple laboratory and clinical parameters. Not serum amylase, but serum lipase is an independent predictor of CR-POPF. Our simple nomograms may help in the identification of patients for early postoperative interventions.

scholarly journals Fetus in fetu: two case reports from North African country

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Moutaz Ragab ◽  
Omar Nagy Abdelhakeem ◽  
Omar Mansour ◽  
Mai Gad ◽  
Hesham Anwar Hussein
Keyword(s):  
Histopathological Examination ◽  
Case Reports ◽  
Abdominal Mass ◽  
Mature Teratoma ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Mass Effect ◽  
Fetus In Fetu ◽  
Vascular Connection ◽  
First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

scholarly journals Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

2020 ◽  
Vol 13 (2) ◽  
pp. e231995
Author(s):  
Brittany Sanford ◽  
Catherine Hoeppner ◽  
Tammy Ju ◽  
Brian K Theisen ◽  
Anna BuAbbud ◽  
...  
Keyword(s):  
General Surgery ◽  
Case Reports ◽  
Hepatocellular Adenoma ◽  
Multidisciplinary Care ◽  
Exploratory Laparotomy ◽  
Pregnant Patient ◽  
Haemorrhagic Shock ◽  
Liver Adenoma ◽  
Life Threatening ◽  
Temporary Closure

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

scholarly journals Valproate semisodium-induced encephalopathy: diet and polypharmacy interactions

2012 ◽  
Vol 36 (4) ◽  
pp. 137-139 ◽  
Author(s):  
Nuno Rodrigues Silva ◽  
Ângela Venâncio
Keyword(s):  
Case Reports ◽  
Adult Population ◽  
Paediatric Population ◽  
Valproate Semisodium ◽  
Bipolar I Disorder ◽  
Life Threatening ◽  
Life Threatening Complication

SummaryDespite extensive use of valproate in neurology and psychiatry, valproate-induced encephalopathy is a rarely reported complication. Although initially reported in the paediatric population, case reports are growing in the adult population.Clinicians need to be aware of this potentially life-threatening complication. We report a case in a 37-year-old woman with bipolar I disorder with previously uncomplicated valproate use, who developed encephalopathy when valproate was restarted a few years later. The patient has provided consent for publication.

HIV/AIDS and traditional healers: a blessing in disguise

2010 ◽  
Vol 50 (3) ◽  
pp. 154-155
Author(s):  
B L Meel
Keyword(s):  
Case Reports ◽  
Health Care Systems ◽  
Traditional Healers ◽  
Immunodeficiency Virus ◽  
Herbal Decoction ◽  
Care Systems ◽  
Life Threatening ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Hiv Aids

Traditional healers contribute significantly to the level of health-care systems in Africa. They could play an important role in the prevention and care of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the community. The traditional healing system deals with psychosocial stress associated with HIV/AIDS as well as herbal medications. Sometimes, herbal medicine causes serious life-threatening complications. Two case reports are presented in this article. The first is a 48-year-old woman with HIV who was made to drink a large volume of a herbal decoction to stimulate vomiting in the belief that cleansing the bowel would rid the system of the disease. The second is a 25-year-old young man who had a herbal enema, which resulted in gangrene of the large bowel. The case histories, mechanism of action and causes of death are discussed.

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