A case of phlegmonous gastritis with hepatic portal venous gas caused by Aeromonas hydrophila successfully treated with medication
A 74-year-old woman was admitted to the hospital with epigastric pain, severe nausea and vomiting, and diarrhea that had started 3 days previously. She had eaten raw Ayu fish 4 days before admission. An abdominal contrast-enhanced computed tomography scan revealed the presence of gas in the portal vein and remarkable thickening of the gastric wall. In many cases, the gas in the portal vein indicates the existence of intestinal necrosis. Esophagogastroduodenoscopy showed a submucosal tumor-like elevation in the gastric corpus. She was diagnosed with sepsis and phlegmonous gastritis (PG) with hepatic portal venous gas (HPVG) caused by Aeromonas hydrophila, which was detected in her stool. The patient was treated with antibiotics and discharged from the hospital 23 days after admission in a stable condition. When caused by PG, HPVG is not necessarily considered a poor prognostic factor and is expected to be treatable with medication. However, patients should be closely monitored for signs of a life-threatening pathology such as intestinal necrosis.
KeywordsPhlegmonous gastritis Hepatic portal venous gas Aeromonas hydrophila
The authors wish to acknowledge Dr. S. Sugie, Professor of Department of Diagnostic Pathology, Asahi University Hospital, for useful discussions. The authors thank anonymous reviewer for their helpful comments.
Compliance with ethical standards
Conflict of interest
Takeshi Yasuda, Nobuaki Yagi, Yuki Nakahata, Takuya Kurobe, Yuriko Yasuda, Tatsushi Omatsu, Obora Hiroaki, Takao Kojima declear that they have no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients for being included in the study.
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