A Case of the Phlegmonous Gastritis Difficult to Differentiate from Gastric Carcinoma of the Scirrhous Type

Kouichi Higashiyama, Toshiaki Nagase, Masao Fujimaki*

Department of Surgery, Koumi Red Cross Hospital
*Second Department of Surgery, Faculty of Medicine, Toyama Medical and Pharmaceutical University

We report a case of phlegmonous gastritis of the chronic diffuse type in which a gastric ulcer was the focus of infection, and it was preoperatively diagnosed as gastric carcinoma of the scirrhous type. A 64-year-old man, who was admitted to our hospital with acute pneumonia, became nauseated and vomited blood. We diagnosed his illness as gastric carcinoma of the scirrhous type by barium meal and gastroscopy, but histologically there was no malignant finding on biopsy. During surgery the stomach was found to be the size of a fist, and total gastrectomy and splenectomy were performed. Histological examination revealed a shallow ulcer of the stomach with the gastric wall thickened by fibrosis and massive infiltration of plasma cells, which was diagnosed as phlegmonous gastritis of the chronic type. Phlegmonous gastritis is a rare inflammatory disorder of the stomach and it is very difficult to make a definite diagnosis preoperatively. In diagnosis early recognition of this disease should be emphasized.

Key words
phlegmonous gastritis, scirrhous carcinoma, preoperative diagnosis

Reprint requests
Kouichi Higashiyama Department of Surgery, Koumi Red Cross Hospital
80 Koumi-machi, Minamisaku-gun, Nagano, 384-11 JAPAN

Accepted
April 17, 1991

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