Idiopathic granulomatous gastritis with severe gastrointestinal bleeding

Abstract

A 54-year-old woman presented at the emergency service with acute gastrointestinal bleeding. Her haemoglobin level was 6.5 mg/dl and she had hypovolemic shock symptoms. Emergency endoscopy showed a severely bleeding area near the cardia but no open vessel was visualized. As the bleeding could not be stopped by endoscopic intervention and another nonbleeding multiple erosive focus was seen close to the pylorus laparotomy, total gastrectomy was performed. The patient was discharged on postoperative day 6 without any complication. Interestingly, the pathologic examination of the bleeding lesion revealed a granulomatous inflammation. Additional searches to determine the source of the granulomatous inflammation (tuberculosis, Helicobacter pylori, Crohn’s disease, etc.) yielded negative results; hence, the case was classified as idiopathic granulomatous gastritis.

Keywords

• bleeding
• gastritis
• granulomatous
• idiopathic