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DOI: 10.1055/s-2004-813238
© Karl Demeter Verlag im Georg Thieme Verlag KG Stuttgart · New York
Emphysematous Gastritis - Case Report and Review of the Literature
Emphysematöse Gastritis - Ein Fallbericht und Übersicht der Literatur The authors wish to thank Marijana Gajek-Marchetti, translator, from the Medical Research Department of Maribor Teaching Hospital, for her contribution in translating the manuscript.Publikationsverlauf
manuscript received: 27.1.2004
manuscript accepted: 5.5.2004
Publikationsdatum:
16. August 2004 (online)
Zusammenfassung
Die emphysematöse Gastritis ist eine seltene Form der Magenphlegmone, hervorgerufen durch die Invasion gasbildender Bakterien in die Magenwand. Dieses Einheitsbild wurde erstmals von Fränkel im Jahr 1889 beschrieben. Wir berichten über den Fall eines 58-jährigen Patienten mit Niereninsuffizienz im Endstadium, der während des letzten Jahres mittels Hämodialyse behandelt wurde. Er wurde wegen Unterbauchschmerzen aufgenommen. Das diagnostische Verfahren bestätigte eine emphysematöse Gastritis und akute Cholezystitis. Es kam zu einer akuten Bauchfellentzündung, die eine Notlaparotomie verlangte. Während des Eingriffs wurde die nekrotische Gallenblase entfernt. Der Patient starb am Tag darauf wegen mehrfachen Organversagens und septischen Schocks. Luft in der Magenwand ist ein seltener Befund mit einer breiten Differenzialdiagnose. Nach der Fachliteratur ist die emphysematöse Gastritis in der Regel eine tödliche Krankheit.
Abstract
Emphysematous gastritis is a rare form of phlegmonous gastritis caused by invasion of the stomach wall by gas-forming bacteria. This clinical entity was first described by Fraenkel in 1889. The authors report the case of a 58-year-old patient with end-stage renal failure under treatment with hemodialysis for the past year. He was admitted on account of pain in the lower abdomen. During the diagnostic procedure, emphysematous gastritis and acute cholecystitis were confirmed. An acute abdomen developed and an emergency laparotomy was performed. During the procedure, the necrotic gallbladder was removed. The patient died on the following day due to multiorgan failure and septic shock. According to the literature, emphysematous gastritis is generally a fatal disease. Air in the wall of the stomach is a rare finding with a broad differential diagnosis.
Schlüsselwörter
Emphysematöse Gastritis - Niereninsuffizienz im Endstadium - akute Cholezystitis - Notlaparotomie
Key words
Emphysematous gastritis - end-stage renal failure - cholecystitis - emergency laparotomy
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M.D.Ph. D. Ass. Prof. P Skok
Medical Department, Maribor Teaching Hospital
Ljubljanska 5
2000 Maribor
Slovenia
eMail: Pavel.Skok@sb-mb.si