胃蜂巣炎の1例

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  • A CASE OF PHLEGMON OF THE STOMACH

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Phlegmon of the stomach is a nonspecific suppurative inflammation arising from the submucosal layer extending to the full thickness of the stomach. It often presents difficulty in differential diagnosis from advanced gastric cancer. This paper describes a case of gastric phlegmon which did not respond to conservative treatment and demanded a gastrectomy due to passage disturbance.<br> An 85-year-old man was admitted to the internal department in our hospital because of fever and appetite loss. Prior to this admission he was treated at another hospital with a diagnosis of pneumonia for about half a month, but appetite loss appeared. After admission UGIS revealed a circumferential irregularity of the wall, linearity and stricture in the pyloric antrum. GIF showed remarkable redness of the mucosa and irregular multiple erosion in the entire pyloric antrum. Biopsy disclosed potent infiltration of inflammatory cells. With a diagnosis of gastric phlegmon conservative treatment was carried out. Inflammatory findings of he gastric mucosa improved, but the stricture at the pylorus came to significant. The patient was transferred to the department of surgery for operation. A distal gastrectomy was carried out. The resected specimen revealed thickness and ulcer in the gastric wall. Histologically severe submucosal fibrosis and infiltration of inflammatory cells were confirmed without any malignant findings. The definite diagnosis of gastric phlegmon was made.

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