meropenem and Gastritis

Gas is rarely found within the viscera outside the lumen of the gastrointestinal tract. Emphysematous gastritis is a rare form of infection of the stomach wall by gas producing organisms.. A 45-year-old Chinese lady underwent hepatectomy for hepatocellular carcinoma. Postoperatively, she turned septic and encephalopathic with worsening liver function. Computed tomography scan revealed a thickened, oedematous stomach wall with air pockets within.. The patient was started on a course of broad spectrum antibiotics.. She responded and was discharged well.. Emphysematous gastritis is a rare condition with high mortality. There is however, still no preferable approach of treatment despite therapeutic advances.

Topics: Anti-Bacterial Agents; Emphysema; Female; Gastritis; Humans; Meropenem; Middle Aged; Portal Vein; Radiography; Thienamycins; Ultrasonography; Venous Thrombosis

Emphysematous gastritis is a life-threatening disease. It is characterized by the presence of gas within the wall of the stomach. The etiology includes firstly infections with gas-forming organisms; other predisposing causes are the ingestion of corrosive substances and alcohol abuse. Diagnosis is based on radiological techniques, mainly computed tomographic scan (CT). The election treatment is antibiotics and surgery. The evolution is generally fatal. We present the first known case reported, which is associated with aplastic anemia with immunosuppressive therapy, its evolution with medical treatment and a literature review.

Topics: Anemia, Aplastic; Antilymphocyte Serum; Cholelithiasis; Cyclosporine; Emphysema; Female; Gastritis; Granulocyte Colony-Stimulating Factor; Humans; Immunosuppressive Agents; Meropenem; Methylprednisolone; Metronidazole; Middle Aged; T-Lymphocytes; Thienamycins; Tomography, X-Ray Computed

Topics: Acute Disease; Amikacin; Anemia, Aplastic; Antilymphocyte Serum; Combined Modality Therapy; Cyclosporine; Drug Therapy, Combination; Escherichia coli Infections; Gastric Mucosa; Gastritis; Granulocyte Colony-Stimulating Factor; Immunosuppressive Agents; Meropenem; Methylprednisolone; Necrosis; Neutropenia; Omeprazole; Parenteral Nutrition, Total; T-Lymphocytes; Thienamycins

Phlegmonous gastritis is a rapidly progressive bacterial infection of the stomach wall. It has a high mortality rate and aggressive treatment, either with antibiotics or surgical resection, is required. Here, we report an extremely rare case of phlegmonous gastritis associated with advanced esophageal cancer. A 65-year-old Japanese man was urgently admitted to the hospital due to pyrexia and gastrointestinal symptoms. Abdominal computed tomography revealed widespread diffuse thickening of the gastric wall. On endoscopic examination, an ulcerative mass was detected at the lower thoracic esophagus, and a markedly elevated submucosal lesion was present in the middle of the stomach body. Biopsy specimens taken endoscopically from the esophageal tumor confirmed a diagnosis of squamous cell carcinoma. Gastric biopsy cultures were positive for Streptococcus viridans, leading to a diagnosis of phlegmonous gastritis associated with esophageal cancer. After the patient's condition improved with preoperative antibiotic administration, we performed a thoracoscopic esophagectomy, a total gastrectomy and a reconstruction of the gastrointestinal tract using a pedicled right colon. Histological examination of the resected specimen confirmed that the gastric mass was compatible with a phlegmon.

Topics: Aged; Anti-Bacterial Agents; Carcinoma, Squamous Cell; Esophageal Neoplasms; Esophagectomy; Gastrectomy; Gastritis; Humans; Male; Meropenem; Streptococcal Infections; Thienamycins; Viridans Streptococci

A 64-year-old man presented with epigastralgia and nausea after an acute exacerbation of chronic pancreatitis. Abdominal computed tomography revealed remarkable thickening of the gastric wall and intramural hypodense areas. Esophagogastroduodenoscopy showed a large gastric ulcer surrounded by an edematous mucosa and mucopus. The results of a culture from a biopsy of the lesion indicated phlegmonous gastritis. The patient was successfully treated with an antibiotic without gastrectomy.

Topics: Anti-Bacterial Agents; Cellulitis; Endoscopy, Digestive System; Gastritis; Humans; Male; Meropenem; Middle Aged; Omeprazole; Pancreatitis, Chronic; Proton Pump Inhibitors; Thienamycins; Tomography, X-Ray Computed; Treatment Outcome