A Rare case of Menetrier’s disease presenting with Protein Losing Gastropathy Mimicking Carcinoma Stomach

Ménétrier's disease (MD) (also known as giant hypertrophic gastritis or hypoproteinemic hypertrophic gastropathy) is a rare premalignant entity characterized by markedly hypertrophied mucosal folds of the fundus and the gastric corpus typically associated with , hypochlorhydria, protein losing enteropathy causing hypoalbuminemia and anemia. However, the natural history of MD in adults remains unclear and is rarely reported in the literature. Its constellation of classic symptoms includes nausea, vomiting, abdominal pain and peripheral edema, and it is associated with increased risk of gastric cancer. Nevertheless, its pathophysiology is not yet fully understood and clinical and endoscopic diagnosis can be difficult to establish. Malignant transformation in MD should not be overlooked, and regular monitoring of the gastric mucosa via endoscopy is necessary.

GASTRITIS AND HELICOBACTER PYLORI IN CHILDREN – PRIMARY AND SECONDARY ENDOSCOPIC DIAGNOSIS

The infection with Helicobacter pylori (H pylori) represents an important issue of public health. Aim. Establishing the prevalence of H. pylori infection in children and presenting the cases according to the gastritis type by performing upper digestive endoscopies. Material and method. The retrospective study referred to a period of 5 years and included 1269 children evaluated by upper endoscopy to establish the H. pylori infection rate. Results. The frequency of H. pylori in the case of acute gastritis was significantly more reduced (34.78%) than in the case of chronic gastritis (54.94%). Referring to the 10 types of gastritis, the most frequent ones are purpuric (43.66%), nodular purpuric (25.93%) and nodular antral (15.84%). At the other end, atrophic and hypertrophic gastritis were positioned. The most frequent associations pointed out endoscopically are those with 1st degree esophagitis - 51.6%, duodenitis – 45.07% and purpuric duodenitis – 24.74%.Conclusions. The H. pylori infection is the most frequent etiologic factor for chronic gastritis (54.94%). The early identification of the infection is essential to destroy the bacteria and to prevent the development of various types of gastritis that are later on endoscopically identified.

Canine Giant Hypertrophic Gastritis Treated Successfully with Partial Gastrectomy

A 4 yr old castrated male Jack Russell terrier was presented with a 2 mo history of vomiting, anorexia, and weight loss. Abdominal radiographs and ultrasound supported the diagnosis of gastric outflow obstruction. Celiotomy and gastrotomy revealed a large, narrowly based mass originating from the mucosa of the dorsal gastric body, occupying the lumen of the stomach and protruding through the pylorus into the duodenum. A partial gastrectomy was performed to excise the mass along with a 1 cm margin of grossly normal tissue. Giant hypertrophic gastritis was diagnosed via histopathology of the excised tissue. Giant hypertrophic gastritis is a rarely diagnosed disease of canines, characterized by giant gastric folds, hypoalbuminemia, and mucosal hypertrophy. Long-term treatment success has not been previously reported. In the case described herein, surgical excision of the affected gastric tissue provided complete resolution of clinical signs. Twelve mo following surgery, no recurrence of either vomiting or weight loss had been noted and the dog was clinically normal.