What is phlegmonous gastritis?

Updated: Jul 12, 2020
  • Author: Sarah El-Nakeep, MD; Chief Editor: BS Anand, MD  more...
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Phlegmonous gastritis is an uncommon form of gastritis caused by numerous bacterial agents, including streptococci, staphylococci, Proteus species, Clostridium species, and Escherichia coli. Phlegmonous gastritis usually occurs in individuals who are debilitated. It is associated with a recent large intake of alcohol, a concomitant upper respiratory tract infection, and acquired immunodeficiency syndrome (AIDS). Phlegmonous means a diffuse spreading inflammation of or within the connective tissue. In the stomach, it implies infection of the deeper layers of the stomach (submucosa and muscularis). As a result, purulent bacterial infection may lead to gangrene.

Phlegmonous gastritis is rare. The clinical diagnosis is usually established in the operating room, as these patients present with an acute abdominal emergency requiring immediate surgical exploration. Without appropriate therapy, phlegmonous gastritis can progress to peritonitis and death.

Acute necrotizing hemorrhagic gastritis (a rare variant of phlegmenous gastritis) is mostly related to bacterial infection, which could progress to gastric gangrene. More recently, it has also been associated with new chemotherapeutic drugs, such as multi-antityrosine kinase (midostaurin) which is used in acute myloid leukemia. Necrotizing gastritis cases are severe and may mandate emergency gastrectomy. [1]

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