Development of pseudomembranes in the gastrointestinal tract during acute inflammatory or vascular disease has been confined to the small and/or large bowel, with rare occurrences in the esophagus. Primary gut involvement by Aspergillus is a rare and often fatal complication of intensive antileukemic therapy. To our knowledge, there has been only two case reports of pseudomembranous gastritis. We experienced a case of isolated pseudomembranous gastritis due to Aspergillus after chemotherapy for relapsed acute myelogenous leukemia. The diagnosis was made by gastrofiberscopic findings and histologically.
Aspergillosis ; Aspergillus* ; Diagnosis ; Drug Therapy ; Esophagus ; Gastritis* ; Gastrointestinal Tract ; Humans ; Leukemia, Myeloid, Acute* ; Vascular Diseases

Emphysematous gastritis is a rare form of gastritis caused by infection of the stomach wall by gas forming bacteria. It is a very rare condition that carries a high mortality rate. Portal venous gas shadow represents elevation of intestinal luminal pressure which manifests as emphysematous gastritis or gastric emphysema. Literature reviews show that the mortality rate is especially high when portal venous gas shadow is present on CT scan. Until recently, the treatment of emphysematous gastritis has been immediate surgical intervention. However, there is a recent trend of avoiding surgery because of the frequent occurrence of post-operative complications such as anastomosis leakage. In addition, aggressive surgical treatment has failed to show significant improvement in prognosis. Recently, the authors experienced a case of emphysematous gastritis accompanied by portal venous gas which was treated successfully by conservative treatment without immediate surgical intervention. Herein, we present a case of emphysematous gastritis with concomitant portal venous air along with literature review.
Aged, 80 and over ; Emphysema/complications/*diagnosis/drug therapy ; Female ; Gastritis/complications/*diagnosis/drug therapy ; Gastroscopy ; Humans ; Portal Vein ; Proton Pump Inhibitors/therapeutic use ; Tomography, X-Ray Computed

Chronic Disease ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Gastritis ; diagnosis ; drug therapy ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Reference Standards

Adult ; Ascites ; diagnosis ; etiology ; Biopsy ; Diagnosis, Differential ; Duodenal Obstruction ; diagnosis ; etiology ; Endoscopy, Gastrointestinal ; Enteritis ; complications ; drug therapy ; Eosinophilia ; complications ; drug therapy ; Gastritis ; complications ; drug therapy ; Humans ; Intestinal Mucosa ; pathology ; Male ; Tomography, X-Ray Computed

This report is about the case of gastritis associated with capillariasis. The patient was a 52-yr-old Korean woman who occasionally ate raw fish and chicken. She complained of mild abdominal pain and nausea, but not diarrhea. An endoscopic examination revealed an exudative flat erosive change on the gastric mucosa of the antrum. She was microscopically diagnosed as chronic gastritis with numerous eosinophil infiltrations. The sectioned worms and eggs in mucosa were morphologically regarded as belonging to the genus Capillaria. This is the first case of gastric capillariasis reported in the Republic of Korea.
Albendazole/therapeutic use ; Animals ; Antiprotozoal Agents/therapeutic use ; *Capillaria ; Endoscopy, Gastrointestinal ; Enoplida Infections/*diagnosis/drug therapy ; Female ; Gastric Mucosa/parasitology/*pathology ; Gastritis/*diagnosis ; Humans ; Middle Aged

BACKGROUND: Since the international guideline of Helicobacter pylori eradication therapy was introduced into Korea, many reports about eradication outcomes have been documented. These data were published mostly from referred university hospital. However, in Korea, majority of patients has been treated with H.pylori eradication regimen in primary care setting. This study was performed to investigate the eradication rate of H. pylori in primary care office of Seoul, Korea. METHODS: Total 173 patients with H.pylori-positive gastroscopy results received eradication regimen-mainly one week PPI based triple therapy-from January 1998 to March 2003. Four weeks after completion of medication, urea breath test, biopsy and CLO test were performed to detect H.pylori. RESULTS: Total eradication rate was 87.9%. The eradication rate of male and female were 90.3% and 84.3%, respectively (p>0.05). The eradication rate of patients older than younger than 60 was 81.5% vs 89.0%, respectively (p>0.05). There was no statistical significance in annual eradication rate. In eradication rate, there was no significant difference among PPI regimen (omeprazole, rabeprazole, pantoprazole). Whether endoscopic diagnosis is gastric ulcer or duodenal ulcer, there was no statistical difference in eradication rate between them. In the same way, there was also no statistical difference between peptic ulcer and H.pylori associated gastritis. CONCLUSION: The current eradication rate of H. pylori in primary care setting of Korea was 87.9%. H.pylori eradication rate in primary care setting was not much different from that in referred hospital in Korea, but it was lower than that reported by controlled trials of 1995 (initial times of introduction of international guide line into Korea). So far, the results have been acceptable, but there still remains to be investigated in PPI-based triple therapy as H.pylori eradication in primary care setting in the future of Korea.
Biopsy ; Breath Tests ; Diagnosis ; Drug Therapy ; Duodenal Ulcer ; Female ; Gastritis ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea* ; Male ; Peptic Ulcer ; Primary Health Care* ; Rabeprazole ; Seoul ; Stomach Ulcer ; Urea

OBJECTIVETo study the expressions of gastric mucosal proteins in chronic gastritis (CG) rats of Pi-Wei damp-heat syndrome (PWDHS), to investigate the pathogenesis correlated to CG rats of PWDHS, to observe the differential expressions of gastric mucosal proteins in CG rats of PWDHS, and to investigate the mechanisms of Sanren Decoction (SD) for treating CG rats of PWDHS.

METHODSTotally 36 male SD rats were adaptable fed for 3 days and randomly divided into 3 groups, i.e., the normal control group, the CG of PWDHS rat model group (abbreviated as the model group), and the SD treatment group, 12 in each group. The CG of PWDHS rat model was prepared by composite factors. The gastric mucosal protein was separated using two-dimensional gel electrophoresis technique, and stained by Coomassie brilliant blue. The protein spots expressed differently were analyzed by PDquest 8.0 software. The protein spots expressed differently was identified by MALDI-TOF/TOF-MS.

RESULTSThe protein spots were 1 025 +/- 3 9, 994 +/- 51, 1 087 +/- 33 in the normal control group, the model group, and the SD treatment group respectively detected from two-dimensional gel electrophoresis profiles. Compared with the normal control group, there were 74 protein spots differentially expressed in the model group, 30 spots up-regulated and 44 spots down-regulated. Compared with the model group, there were 75 protein spots differentially expressed in the SD treatment group, 49 spots up-regulated and 26 spots down-regulated. Five protein spots differentially expressed were successfully identified, i.e., heat shock protein 72 (HSP72), heat shock protein 60 (HSP60), protein disulfide-isomerase (PDI), malate dehydrogenase (MDH), and unnamed protein.

CONCLUSIONSThe pathogenesis of CG of PWDHS may be correlated to energy metabolism disturbance and stress. The mechanisms of SD for treating it may possibly adjust differential expressions of gastric mucosal proteins.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Gastric Mucosa ; metabolism ; Gastritis ; diagnosis ; drug therapy ; metabolism ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Proteome ; metabolism ; Rats ; Rats, Sprague-Dawley

UNLABELLED(GPL) in patients suffered from chronic atrophic gastritis (CAG) differentiated as Pi-deficiency with damp-heat retention and blood stasis in TCM Syndrome differentiation.

METHODSSixty-eight patients fitting to the admission criteria were randomly divided into two groups, 36 patients were treated with KWG in the treated group and 32 were treated with Weifuchun in the control group, all were treated for 2 treatment courses (12 weeks as one course).

RESULTSThe curative effects on gastroscopy and pathologic changes in the treated group were significantly superior to those in the control group (P < 0.05). The comparison of clinical efficacy, symptom improvement, anti-Helicobactor pylori effect between the two groups was insignificantly different (P > 0.05).

CONCLUSIONKWG is an effective drug for GPL.

Adult ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastric Mucosa ; pathology ; Gastritis, Atrophic ; drug therapy ; pathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Precancerous Conditions ; drug therapy ; pathology

BACKGROUND/AIMS: In pediatrics, endoscopic examination has become a common procedure for evaluation of gastrointestinal presentations. However, there are limited data on pediatric endoscopy in Korea. The aim of this study was to analyze the current status and clinical impacts of endoscopic examination in children and adolescents. METHODS: We retrospectively reviewed the medical records of outpatients who visited the tertiary hospital. Patients under 18 years of age who underwent endoscopy were included. Endoscopic findings were classified as specific and normal based on gross findings. Specific endoscopic findings were reflux esophagitis, peptic ulcers, and Mallory-Weiss tear. Other findings included acute gastritis classified according to the updated Sydney system. RESULTS: In 722 of 330,350 patients (0.2%), endoscopic examination (554 esophagogastroduodenoscopies [EGDs], 121 colonoscopies, 47 sigmoidoscopies) was performed between January 2008 and January 2013. In EGD, abdominal pain was the most frequent presentation (64.1%). The most common diagnosis was gastritis (53.2%), followed by reflux esophagitis. The frequency of peptic ulcer disease was 12.8%. Frequent symptoms leading to colonoscopic examination were abdominal pain, diarrhea, and hematochezia. In colonoscopy, a negative result was more likely in children younger than 7 years old. After the procedure, the diagnostic yield of EGD and colonoscopy was 88.1% and 45.8%, respectively, and the rate of change in management was 67.1%. CONCLUSIONS: In pediatrics, endoscopic examination was useful for the choice of therapeutic strategy and it would be a standard method for evaluation of gastrointestinal presentation.
Abdominal Pain ; Adolescent ; Child ; Child, Preschool ; *Endoscopy, Digestive System ; Esophagitis, Peptic/diagnosis/drug therapy ; Female ; Gastritis/diagnosis/drug therapy ; Gastrointestinal Hemorrhage/diagnosis ; Histamine H2 Antagonists/therapeutic use ; Humans ; Infant ; Infant, Newborn ; Inflammatory Bowel Diseases/diagnosis ; Male ; Peptic Ulcer/diagnosis/drug therapy ; Proton Pump Inhibitors/therapeutic use ; Republic of Korea ; Retrospective Studies ; Tertiary Care Centers

Acute phlegmonous gastritis is an uncommon disease, often fatal condition characterized by suppurative bacterial infection of the gastric wall. It has a high mortality rate mainly because the diagnosis is usually made late. Until recently, gastrectomy in combination with antibiotics was recommended. We had experienced a case of 66-year-old man presented with epigastric pain, nausea, vomiting, and hematemesis, followed by aspiration pneumonia. At upper gastrointestinal endoscopy, the gastric lumen was narrow, and the mucosa was severely inflamed, which was erythematous, swelled, and showed necrotic areas covered with purulent exudate. Klebsiella oxytoca and Acinetobacter lwoffii were isolated in the gastric tissue culture. Contrast-enhanced computerized tomography scan of abdomen demonstrated diffuse gastric wall thickening and an intramural abscess in the gastric antral wall. Although delayed gastric emptying by gastroparesis prolonged the in-hospital period, the only medical treatment with antibiotics alone successfully cured the patient without gastrectomy.
Acinetobacter/isolation & purification ; Acute Disease ; Aged ; Anti-Bacterial Agents/*therapeutic use ; Anti-Infective Agents/therapeutic use ; Cefotaxime/therapeutic use ; Ceftriaxone/therapeutic use ; Ciprofloxacin/therapeutic use ; Drug Resistance, Multiple, Bacterial ; Drug Therapy, Combination ; Gastritis/*diagnosis/drug therapy/microbiology ; Gastroparesis/*diagnosis/microbiology ; Gastroscopy ; Humans ; Imipenem/therapeutic use ; Klebsiella oxytoca/isolation & purification ; Male ; Ofloxacin/therapeutic use ; Pneumonia/diagnosis/drug therapy ; Tomography, X-Ray Computed