Abstract

BackgroundGastritis cystica polyposa (GCP) is a recently recognized entity histologically characterized by hyperplasia and cystic dilatation of the gastric glands spreading through the submucosal layer. Its symptoms include those affecting the upper gastrointestinal tract, such as upper abdominal pain, nausea, and anorexia, although some patients might be asymptomatic. GCP rarely causes severe hemorrhage. Recently, we encountered a GCP case that exhibited severe hemorrhage.Case presentationA 53 year-old man visited the emergency department complaining of hematemesis. He underwent distal gastrectomy and Billroth II reconstruction for duodenal ulcers 32 years ago. Upper gastrointestinal endoscopy detected bleeding from the reddened mucosa at the anastomosis; thus, tentative endoscopic hemostasis was conducted. Despite medical treatment with transfusion, melena with significant hemodynamic impairment persisted. He was treated again with endoscopic hemostasis and interventional radiology (IVR) but remained unresponsive to these procedures. He eventually underwent partial resection of the anastomosis site with Roux-en-Y reconstruction and finally achieved excellent postoperative recovery. Histopathological examination of the resected specimen suggested a GCP bleeding.ConclusionsGCP can indeed cause severe hemorrhage. Hemorrhage caused by GCP may not respond to endoscopic hemostasis or IVR; therefore, surgical treatment should be decided without delay.

Highlights

  • Gastritis cystica polyposa (GCP) is a recently recognized entity histologically characterized by hyperplasia and cystic dilatation of the gastric glands spreading through the submucosal layer

  • Hemorrhage caused by GCP may not respond to endoscopic hemostasis or interventional radiology (IVR); surgical treatment should be decided without delay

  • Gastritis cystica polyposa (GCP) is a disease proposed by Littler and Gleibermann in 1972, which is a hypertrophic lesion that affects mostly the residual stomach after gastric surgery [1]

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Summary

Introduction

Gastritis cystica polyposa (GCP) is a recently recognized entity histologically characterized by hyperplasia and cystic dilatation of the gastric glands spreading through the submucosal layer. Hemorrhage caused by GCP may not respond to endoscopic hemostasis or IVR; surgical treatment should be decided without delay. *Correspondence: myoshikawa1968@yahoo.co.jp 1 Department of Internal Medicine, Kokuho Central Hospital, 404‐1 Miyako, Tawaramoto, Nara Prefecture 636‐0302, Japan Full list of author information is available at the end of the article gastritis proposed by Koga et al [3].

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Conclusion

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