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Emphysematous Gastritis with Concomitant Portal Venous Air and Acute Necrotizing Esophagitis in Type 1 Diabetes with Diabetic Ketoacidosis: A Case Report and Literature Review of a Rare Complication in Diabetes / 임상당뇨병
Journal of Korean Diabetes ; : 139-145, 2016.
Article in Korean | WPRIM | ID: wpr-726781
ABSTRACT
Emphysematous gastritis is a rare disorder characterized by emphysematous change of the gastric wall due to infection with a gas-forming organism. Acute necrotizing esophagitis is a rare disorder with an unknown pathogenesis. Above two disorders rarely occur together, only three global cases have been reported to date. Such a case has never been reported in Korea, we report a novel case of severe emphysematous gastritis with concomitant portal venous air and acute necrotizing esophagitis in type 1 diabetes presenting with diabetic ketoacidosis. A 24-year-old man known to have type 1 diabetes and pulmonary tuberculosis was brought to the emergency room for epigastric pain with vomiting. His body mass index was 14.7, and the laboratory findings demonstrated leukocytosis and acidosis, as well as elevated serum glucose, ketone, and C-reactive protein levels. Enhanced computed tomography showed portal vein gas and edematous wall thickening without enhancement in the stomach wall, with air density along the stomach and esophageal wall. The patient required surgical intervention of total gastrectomy and cervical esophagostomy followed by esophagocolostomy and esophageal reconstruction. Early radiologic diagnosis and clinical suspicion of this disease and prompt intervention including antibiotics, decompression, and surgery are important for a good prognosis.
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Portal Vein / Prognosis / Stomach / Acidosis / Tuberculosis, Pulmonary / Vomiting / Blood Glucose / C-Reactive Protein / Esophagostomy / Body Mass Index Type of study: Diagnostic study / Prognostic study Limits: Humans Country/Region as subject: Asia Language: Korean Journal: Journal of Korean Diabetes Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Portal Vein / Prognosis / Stomach / Acidosis / Tuberculosis, Pulmonary / Vomiting / Blood Glucose / C-Reactive Protein / Esophagostomy / Body Mass Index Type of study: Diagnostic study / Prognostic study Limits: Humans Country/Region as subject: Asia Language: Korean Journal: Journal of Korean Diabetes Year: 2016 Type: Article