scholarly journals Necrotizing gastritis: a case report

2017 ◽  
Vol 4 (10) ◽  
pp. 3535
Author(s):  
Tejas A. P. ◽  
S. Rajagopalan ◽  
Rohit K.
Keyword(s):  
Case Reports ◽  
Gastric Wall ◽  
Gastric Volvulus ◽  
Tube Placement ◽  
Gelatin Sponge ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Necrosis ◽  
Fatal Disease ◽  
Gastric Gangrene ◽  
Upper Gastrointestinal

Gangrene of the stomach is a rare and often fatal disease. It occurs when there is vascular anomalies, gastric volvulus or herniation and in infectious gastritis. A 65-year-old man was wheeled into the Emergency Department with complaints of abdominal pain for 8 hours. The pain was in the epigastric region which was severe in nature continuous and associated with nausea. There was no history of hematemesis or vomiting. The past medical history was not significant. He was HIV negative. On examination, he was in agonizing pain and tachypneic. The vital signs were temperature 98.6°F, pulse 118/minut, respiratory rate 28/minutes, BP 90/60 mmHg. Abdominal examination found diffuse tenderness with voluntary guarding and rigidity. Bowel sounds were sluggish. Rectal examination was normal. The Ryle’s tube showed hemorrhagic aspirate. Erect X-ray abdomen showed large gastric air fluid level and no evidence of pneumoperitoneum. Routine hemogram showed leukocytosis. Blood sugar level and serum urea, creatinine levels were within normal limits. After initial resuscitation with intravenous fluids and antibiotics, decision was taken to proceed for an emergency exploratory laparotomy. Gastric necrosis is a rare and fatal condition. Etiology includes thromboembolism and occlusion of major arterial supply, ingestion of corrosive agents, volvulus of the stomach, herniation of the stomach through the diaphragm, bulimia nervosa, iatrogenic gelfoam embolism, endoscopic hemostatic injections and infectious gastritis. So, the most probable cause of the gastric necrosis was infectious gastritis. It begins as phlegmonous (suppurative) gastritis (PG), and then it progresses to the lethal severe form: acute necrotizing gastritis. The few case reports of gastric gangrene are there in literature with the underlying etiological factors. Harvey et al, reported a rare case of multifocal infarction of stomach secondary to atheromatous emboli originating in a thoracic aortic aneurysm. Bradly et al, reported a case of extensive gastric necrosis in a patient with recurrent massive upper gastrointestinal hemorrhage. They found massive gastric gangrene secondary to therapeutic transcatheter embolization of the left gastric artery with fragments of gelatin sponge. Ovnat et al, reported three cases of acute obstruction of the celiac trunk. In all the three patients, the mucosa along the lesser curvature of the stomach was necrotic but the gross appearance of the stomach was only mildly ischemic. Organisms isolated from the gastric wall include hemolytic streptococci, proteus, E. coli and clostridium welchi. PG can be diagnosed by upper gastrointestinal endoscopy, CT scan, or endoscopic ultrasound. Its endoscopic findings can show purple colored gastric mucosa covered with dirty necrotic materials. Absolute diagnosis is made, most frequently at laparotomy. Gastric gangrene due to necrotizing gastritis is a rare and fatal disease. The diagnosis is usually made at laparotomy. Treatment consists of resection and feeding tube placement followed by intravenous antibiotics. Increased awareness of this rare entity may lead to more prompt diagnosis and an increased chance for patient survival.

scholarly journals Acute Gastric Volvulus on Hiatal Hernia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Abdessamad EL KAOUKABI ◽  
Mohamed MENFAA ◽  
Samir HASBI ◽  
Fouad SAKIT ◽  
Abdelkrim CHOHO
Keyword(s):  
Hiatal Hernia ◽  
Gastrointestinal Endoscopy ◽  
Epigastric Pain ◽  
Gastric Volvulus ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Entity ◽  
Midline Laparotomy ◽  
Acute Gastric Volvulus ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

scholarly journals Intramucosal esophageal dissection after esophagogastroduodenoscopy: two case reports

2021 ◽  
pp. 198
Author(s):  
Keyword(s):  
Ct Scan ◽  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Upper Gastrointestinal Endoscopy ◽  
Conservative Approach ◽  
First Case ◽  
Esophageal Dissection ◽  
Dental Arcade ◽  
Sharp Foreign Body ◽  
Upper Gastrointestinal

Introduction: Intramucosal esophageal dissection (IED) is an uncommon disorder, described as the separation of the mucosa and/or submucosa from deeper muscular layers due to abrupt increase in intraesophageal pressure. Case presentation: The first case il that of a 52 – years old female patient who underwent an esophagogastroduodenoscopy for control. After the procedure an extensive subcutaneous emphysema of the neck and a massive pneumomediastinum occurred. The patient was successfully treated with a conservative approach. The second case is that of a 43-years old male patient affected by Down’s Syndrome, who underwent an esopagogastroduodenoscopy because of persisting dysphagia. The endoscopic showed the presence of a serrated stricture at 20 centimeters from dental arcade. After the procedure he fell dysphagia. A neck-chest TC-SCAN showed superior and posterior pneumomediastinum and subcutaneous emphysema, without signs of mediastinitis. The patient was successfully treated with conservative approach. After a few days, a new chest CT-SCAN showed the presence of an anomalous right subclavian artery arising from the descending part of the aortic arch, causing dysphagia lusoria. Discussion: The causes of IED include iatrogenic instrumentation, hemostatic applications, mucosal injuries from ingestion of sharp foreign body, or spontaneous. A fluoroscopic upper gastrointestinal series or upper gastrointestinal endoscopy has been widely used to diagnose IED. CT and magnetic resonance are useful for differential diagnosis. In the absence of signs of mediastinitis management is conservative. Conclusion: CT SCAN should be the first exam to perform in the suspicion of IED. The first line treatment should be conservative. In case of the onset of complications and in patients who are refractory to conservative management, endoscopic or surgical treatment are indicated.

scholarly journals Gastric volvulus following diagnostic upper gastrointestinal endoscopy: a rare complication

2014 ◽  
Vol 2014 (feb10 1) ◽  
pp. bcr2013202833-bcr2013202833 ◽  
Author(s):  
V. S. Karthikeyan ◽  
S. C. Sistla ◽  
D. Ram ◽  
N. Rajkumar
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Rare Complication ◽  
Gastric Volvulus ◽  
Upper Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal

scholarly journals Syncope with Surprise: An Unexpected Finding of Huge Gastric Diverticulum

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Mauro Podda ◽  
Jenny Atzeni ◽  
Antonio Messina Campanella ◽  
Alessandra Saba ◽  
Adolfo Pisanu
Keyword(s):  
Ct Scan ◽  
Gastric Wall ◽  
Gastric Fundus ◽  
Upper Gastrointestinal Endoscopy ◽  
Unexpected Finding ◽  
Diagnostic Challenge ◽  
Medical Department ◽  
Postprandial Fullness ◽  
Gastric Diverticulum ◽  
Upper Gastrointestinal

A gastric diverticulum is a pouch protruding from the gastric wall. The vague long clinical history ranging between dyspepsia, postprandial fullness, and upper gastrointestinal bleeding makes this condition a diagnostic challenge. We present a case of large gastric diverticulum that has been diagnosed during clinical investigations for suspected cardiovascular issues in a patient admitted at the medical ward for syncope. A 51-year-old man presented to the medical department due to a syncopal episode occurring while he was resting on the beach after having his lunch, with concomitant vague epimesogastric gravative pain without any other symptom. A diagnosis of neuromediated syncopal episode was made by the cardiologist. Due to the referred epimesogastric pain, an abdominal ultrasound scan was carried out, showing perisplenic fluid. A CT scan of the abdomen was performed to exclude splenic lesions. The CT scan revealed a large diverticulum protruding from the gastric fundus. The upper gastrointestinal endoscopy visualized a large diverticular neck situated in the posterior wall of the gastric fundus, partially filled by undigested food. The patient underwent surgery, with an uneventful postoperative course. Histologic examination showed a full-thickness stomach specimen, indicative of a congenital diverticulum. At the 2nd month of follow-up, the patient was asymptomatic.

scholarly journals Rapunzel Syndrome in a Seven-Year-Old Girl

2021 ◽  
Author(s):  
Aviral Gupta ◽  
Sarvesh C. Mishra ◽  
Vijay D. Upadhyay ◽  
Pujana Kanneganti
Keyword(s):  
Abdominal Pain ◽  
Gold Standard ◽  
Gastrointestinal Endoscopy ◽  
Case Reports ◽  
Abdominal Mass ◽  
Upper Gastrointestinal Endoscopy ◽  
Surgical Removal ◽  
Rare Entity ◽  
Rapunzel Syndrome ◽  
Upper Gastrointestinal

AbstractRapunzel syndrome is a rare entity with less than hundred case reports cited in the literature. In this, there is presence of a trichobezoar in the stomach which extends into the small intestine or beyond. It can typically cause abdominal pain and nausea, but can also present as an asymptomatic abdominal mass, progressing to abdominal obstruction and perforation. Many of these patients have associated psychiatric disorder. The gold standard for diagnosis is upper gastrointestinal endoscopy and treatment is surgical removal. Herein, we present surgical images of Rapunzel syndrome in a seven-year-old girl.

scholarly journals Measurement of intragastric pressure: an objective method to ascertain whether gastric wall extension is sufficient for assessment of the non-extension sign

2021 ◽  
Vol 09 (04) ◽  
pp. E530-E536
Author(s):  
Kentaro Imamura ◽  
Motoko Machii ◽  
Kenshi Yao ◽  
Suketo Sou ◽  
Takashi Nagahama ◽  
...  
Keyword(s):  
Pressure Measurement ◽  
Gastrointestinal Endoscopy ◽  
Gastric Wall ◽  
Accurate Method ◽  
Upper Gastrointestinal Endoscopy ◽  
Intragastric Pressure ◽  
Strong Extension ◽  
Upper Gastrointestinal

Abstract Background and study aims The optimal intragastric pressure (IP) for strong gastric wall extension is unclear. We aimed to develop an accurate method to measure IP using endoscopy and determine the pressure required for strong gastric wall extension. Methods An in vitro experiment using an endoscope with a rubber attached at its tip was conducted. The process of inserting the pressure measurement probe into the forceps channel was skipped, and the tube of the pressure measurement device was directly connected to the forceps channel. In vivo, the pressure in 51 consecutive patients at the time of strong gastric wall extension was measured. Strong extension of the gastric wall was defined as when the folds in the greater curvature were flattened as a result of sufficient extension of the gastric wall by insufflated air during upper gastrointestinal endoscopy. The IP at that time was measured. Results In vitro, 20 mL of tap water was injected once into the forceps channel and then aspirated for 10 seconds. Pressure measurement after irrigation of the forceps channel as well as the measurement by inserting the probe procedure were accurately performed. In vivo, among the 51 included patients, the mean IP (range) was 14.7 mmHg (10–23). Strong extension of the gastric wall was obtained in 96.1 % of patients when the IP was 20 mmHg. Conclusions We developed an accurate method to measure IP using upper gastrointestinal endoscopy. Strong extension of the gastric wall was obtained in almost all patients when the IP was 20 mmHg.

scholarly journals Mallory–Weiss syndrome complicated by severe aspiration pneumonitis in an infant

2021 ◽  
Vol 2021 (10) ◽  
Author(s):  
Yukako Ebara ◽  
Akihiko Shimizu ◽  
Shigeru Nomura ◽  
Akira Nishi ◽  
Yoshiyuki Yamada
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Bleeding ◽  
Case Reports ◽  
Multidisciplinary Treatment ◽  
Aspiration Pneumonitis ◽  
Upper Gastrointestinal Endoscopy ◽  
Pediatric Case ◽  
Respiratory Condition ◽  
Linear Scar ◽  
Upper Gastrointestinal

ABSTRACT A 1-month-old girl presented with hematemesis and dyspnea. A large amount of blood was aspirated through a nasogastric tube, and chest computed tomography showed bilateral centrilobular opacified lesions, which suggested aspiration pneumonitis due to upper gastrointestinal bleeding. Her respiratory condition exacerbated, and we initiated nitric oxide (NO) therapy. Bleeding stopped with conservative treatment. She was weaned off mechanical ventilation and extubated on Day 6 after admission. Afterward, upper gastrointestinal endoscopy showed a longitudinal linear scar indicative of Mallory–Weiss syndrome (MWS). MWS is rarely reported in early infancy since many of the risk factors are absent in infants. Patients with aspiration pneumonitis usually recover respiratory function within 24 h and severe respiratory failure is rare in aspiration pneumonitis. There are no pediatric case reports describing MWS with severe aspiration pneumonitis. Although MWS is a rare cause of neonatal hematemesis, patients can become severely ill and require multidisciplinary treatment.

Unusual cause of severe iron deficiency anaemia in a child: paraoesophageal hernia

2021 ◽  
Vol 14 (3) ◽  
pp. e237728
Author(s):  
Rishi Bolia ◽  
Yash Srivastava ◽  
Renu Yadav ◽  
Poonam Sherwani
Keyword(s):  
Iron Deficiency ◽  
Hiatus Hernia ◽  
Iron Deficiency Anaemia ◽  
Gastrointestinal Endoscopy ◽  
Case Reports ◽  
Occult Blood ◽  
Upper Gastrointestinal Endoscopy ◽  
Deficiency Anaemia ◽  
Paraoesophageal Hernia ◽  
Upper Gastrointestinal

Iron deficiency anaemia is a known complication of a large hiatal hernia in adults. It occurs as a result of erosions on the gastric mucosa secondary to traction at the hiatus during respiration and/or gastric acid-related injuries to the mucosa. Even though anaemia occurs as a result of chronic gastrointestinal blood loss, testing for faecal occult blood is often negative and upper gastrointestinal endoscopy normal as the bleeding is intermittent. In children, a hiatus hernia as a rare cause of iron deficiency anaemia and has been described only in case reports. Here, we describe a 5-year-old boy who presented with severe transfusion-dependent iron deficiency anaemia caused by a paraoesophageal hernia. Surgical repair of the hiatus hernia led to complete resolution of anaemia. One should consider a hiatus hernia as a diagnostic possibility when evaluating a child with refractory iron deficiency anaemia.

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