早期胃癌が原因と考えられた急性胃蜂窩織炎の1例

This paper describes a case of acute phlegmonous gastritis due to early gastric cancer diagnosed by the gastroendoscopic findings, the intraoperative findings and the histological diagnosis. A 58-year-old man presented with fever, nausea, vomiting and rapidly progressive upper abdominal pain. Gsatrofiberscopy showed remarkable redness and mucosal edema on the distal half portion of the stomach, and the ulcerated lesion in the antrum. We operated him emergently as suspected perforation of the stomach, and found the stomach swelling on the middle body to the antrum with remarkable wall thickness and redness under the laparotomy. Distal gastrectomy was performed on the diagnosis of acute phlegmonous gastritis. Histopathologic examination disclosed that the ulcerated lesion in the antrum was the early gastric cancer, 2.0×1.5cm, well-differentiated adenocarcinoma. The antrum around it had the thickest wall with severe inflammation including neutrophilic infiltration and microabcess, which was also observed to the middle body, although less severe. Acute phlegmonous gastritis is a nonspecific supprant inflammation that is as uncommon as only 111 cases described in the Japanese literature, including the present case. The pathogenesis is still unclear, although predisposing factors like mucosal injury, achlorhydria and immunocompromised state have been mentioned.

P.56誤記あり(誤)Touru Imura → (正) Satoru Imura　(誤） Tokuichi Hanaki → (正) Norikazu Hanaki