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상부위장관 내시경 후 악화된 기종성 위염

Emphysematous Gastritis Worsened after Upper Endoscopy

김태언 ( Kim Tae-Un ) - 양산부산대학교병원 영상의학과

김수진 ( Kim Su-Jin ) - 양산부산대학교병원 내과
류화성 ( Ryu Hwa-Seong ) - 양산부산대학교병원 영상의학과
김진혁 ( Kim Jin-Hyeok ) - 양산부산대학교병원 영상의학과
장주연 ( Jang Joo-Yeon ) - 양산부산대학교병원 영상의학과
염정아 ( Yeom Jeong-A ) - 양산부산대학교병원 영상의학과
노지은 ( Roh Ji-Eun ) - 양산부산대학교병원 영상의학과
정희석 ( Jeong Hee-Seok ) - 양산부산대학교병원 영상의학과
박병수 ( Park Byung-Soo ) - 양산부산대학교병원 외과
김동일 ( Kim Dong-Il ) - 양산부산대학교병원 외과

Abstract


Emphysematous gastritis is an infectious disease in which air is formed in the gastric wall by gas-forming organisms. It is infrequently reported but can be fatal without early diagnosis and treatment. The stomach is rarely infected because of the acidity of the gastric secretions and the rich blood supply. Treatment should be aimed at covering gram-negative organisms and anaerobes using broad-spectrum intravenous antibiotics, and occasional surgical management in order to enhance survival. Risk factors are those that lead to disrupted mucosal integrity, such as corrosive injury, and those that result in an immunosuppressed condition, including diabetes mellitus, chronic kidney disease, immunosuppressive drug use, and subsequent invasion by gas-forming organisms. We experienced a case of emphysematous gastritis that worsened after endoscopy. Aeration during upper endoscopy examination can cause barotrauma to the gastric wall with impairment of the mucosal barrier, resulting in the spread of gastric wall infection to the whole body. Therefore, we report this case and provide relevant literature review to suggest that early endoscopic evaluation can lead to exacerbation of emphysematous gastritis.

키워드

Endoscopy; Gastritis; Hematemesis; Kidney failure, chronic
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