Phlegmonous Gastritis in Chemotherapy-related Neutropenia with Endoscopic Findings that Prompted Early Therapeutic Intervention.
Kazuhiro Ota, Sayaka Tsuji, Masatoshi Kaizuka et al.
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Case in brief
A 56-year-old man with chemotherapy-related neutropenia and immunosuppression presented with shock and epigastric pain. CT showed diffuse gastric wall thickening, while endoscopy demonstrated extensive mucosal injury, raising concern for phlegmonous gastritis. Empiric antimicrobial therapy was started, and he improved with conservative management, with clinical and endoscopic improvement.
What made this case unusual
Extensive mucosal injury on endoscopy helped prompt early treatment in a patient with chemotherapy-related neutropenia, despite the non-specific presentation.
Diagnostic / clinical pearl
In an immunocompromised patient with shock and epigastric pain, gastric wall thickening and extensive mucosal injury should raise suspicion for phlegmonous gastritis and support timely intervention.