Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2023; 11(35): 8357-8363
Published online Dec 16, 2023. doi: 10.12998/wjcc.v11.i35.8357
Diffuse arterial atherosclerosis presenting with acute ischemic gastritis: A case report
Rui-Yao Wei, Jia-Hui Zhu, Xiang Li, Jian-Yong Wu, Jun-Wei Liu
Rui-Yao Wei, Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Jia-Hui Zhu, Jian-Yong Wu, Jun-Wei Liu, Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
Xiang Li, Department of Gastroenterology, Songyang Chinese Medicine Hospital, Lishui 323000, Zhejiang Province, China
Co-first authors: Rui-Yao Wei and Jia-Hui Zhu.
Author contributions: Wei RY and Zhu JH contributed to manuscript writing and editing, and data collection; Li X and Wu JY contributed to data analysis; Liu JW contributed to conceptualization and supervision; All authors have read and approved the final manuscript; Wei RY and Zhu JH contributed equally to this work as co-first authors.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Wei Liu, MD, Doctor, Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. yixiliu120@163.com
Received: August 22, 2023
Peer-review started: August 22, 2023
First decision: November 1, 2023
Revised: November 11, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: December 16, 2023
Processing time: 113 Days and 20 Hours
Abstract
BACKGROUND

Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopathologically. Early diagnosis and treatment can only be achieved through upper gastrointestinal endoscopy after symptoms appear.

CASE SUMMARY

A 68-year-old woman with a history of intracranial aneurysm developed dizziness, chest tightness and unconsciousness for 2 d. Computed tomography angiography showed diffuse coronary atherosclerosis, moderate to severe stenosis in the proximal end of the left anterior descending branch, multiple calcified plaques in the proximal end of the circumflex branch and right coronary artery, and mild to moderate stenosis. The patient also developed diffuse atherosclerosis in the splenic and mesenteric arteries, with mild lumen stenosis and atherosclerosis in the abdominal aorta and its branches. Endoscopy showed submucosal congestion and damage of the entire gastric mucosa, of which the fundus and body of the stomach were most seriously affected. The mucosa was swollen, with a deep purple color, surface erosion and dark red oozing blood. Pathological examination showed bleeding and necrosis of the gastric mucosa, with residual contours of the gastric glands, consistent with ischemic gastritis.

CONCLUSION

Ischemic gastritis is a rare disease that may be difficult to diagnose as its symptoms may be similar to those of other gastrointestinal diseases. Diagnosis is usually based on endoscopic and pathological examinations, which show insufficient blood supply to the gastric mucosa leading to mucosal damage and necrosis.

Keywords: Ischemic gastritis; Endoscopy; Pathological examination; Atherosclerosis; Vascular disease; Case report

Core Tip: Ischemic gastritis is a rare disease characterized by insufficient blood supply to the gastric mucosa, leading to mucosal damage and necrosis. It can occur in patients with various underlying diseases, such as cardiovascular disease, arterial thrombosis or embolism, vasculitis or hypotension. The clinical manifestations of ischemic gastritis range from mild gastrointestinal symptoms to severe bleeding or perforation, and diagnosis is usually based on endoscopic and pathological examination. However, ischemic gastritis may be difficult to diagnose as it may be similar to other gastrointestinal diseases and may require a high degree of suspicion.