Granulomatous Gastritis: Endoscopic and Etiological Features

Aims Granulomatous gastritis (GG) is defined by the presence in the chorion of epithelioid and sometimes gigantocellular granulomas. The aim of our study is to describe the clinical and endoscopic characteristics and to determine the etiologies of GG.

Methods This is a retrospective study of all cases of GG in our departement between 2008 and 2018.

Results Ten patients were included . The mean age was 46.3 years and the sex ratio was 0.25 [M/F = 2/8]. The indication for esogastroduodenal fibroscopy was dominated by epigastralgia in 8 cases (60 %), chronic diarrhea in 1 case (10 %) and vomiting in 1 case (10 %). It was normal in 2 cases. Congestive gastropathy was noted in 4 cases and ulcerated in 4 cases. The location of the granulomas was antral in 4 cases, fundic in 1 case, and antrofundic in 5 cases. An associated chronic Helicobacter pylori (HP) gastritis was noted in 6 cases. A Tuberculosis assessment was carried out in all patients. Thoraco-abdominopelvic CT was performed in all patients to look for deep lymphadenopathy or suspicious thickening.The aetiologies retained were as follows: gastric tuberculosis in three patients (30 %) due to the presence of caseous necrosis on histology, H. pylori was the cause retained for granulomatosis gastritis in three cases (30 %), The diagnosis was made following the disappearance of the granulomas after eradication of Helicobacter Pylori. The diagnosis of sarcoidosis was retained in one patient (10 %). The diagnosis of Crohn’s disease was made in two patients(20 %) and the aetiologic search was unsuccessful in one patient (10 %).

Conclusions Granulomatous gastritis is a rare entity with a variety of etiologies. Their diagnosis is only obtained by combining endoscopic and morphological examinations with the results of clinical and biological investigations.

Citation: Bradai S, Khsiba A, Medhioub M et al. eP67 GRANULOMATOUS GASTRITIS: ENDOSCOPIC AND ETIOLOGICAL FEATURES. Endoscopy 2021; 53: S118.

Publication History

Article published online:
19 March 2021