PMID- 36540428
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221222
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 11
DP  - 2022 Nov
TI  - Non-operative Management of Sarcina ventriculi-Associated Severe Emphysematous 
      Gastritis: A Case Report.
PG  - e31543
LID - 10.7759/cureus.31543 [doi]
LID - e31543
AB  - We report a case of a 64-year-old Jehovah's Witness male, who was post-operative 
      day five of laparoscopic cholecystectomy. He presented with anemia, severe 
      ischemic gastritis, and pneumatosis seen on CT with intravenous contrast. A 
      subsequent upper endoscopy revealed patchy gastric ulceration with bleeding but 
      no overt evidence of perforation. Biopsies were taken, and immunohistological 
      staining identified Sarcina ventriculi. The patient was treated non-operatively 
      with fluconazole and piperacillin-tazobactam for the infection and with 
      sucralfate tablets and pantoprazole injections for ulcer treatment. After five 
      days, a repeat CT scan revealed a resolved pneumatosis. S. ventriculi is a rare 
      bacterium that is increasingly being reported as a cause of emphysematous 
      gastritis with potentially fatal perforation. Surgical intervention should be 
      reserved for unstable patients with perforations and significant, overt bleeding. 
      In this case, non-operative treatment with antibiotics and proton pump inhibitor 
      (PPI) medications were preferred in the setting of anemia in a Jehovah's Witness 
      patient without perforation. The patient showed clinical and radiologic 
      improvement. Further understanding of the role of surgical intervention versus 
      non-operative management is needed for this rare and potentially life-threatening 
      organism.
CI  - Copyright (c) 2022, Birkholz et al.
FAU - Birkholz, Tyler
AU  - Birkholz T
AD  - Department of Internal Medicine, Ohio University Heritage College of Osteopathic 
      Medicine, Warrensville Heights, USA.
FAU - Kim, Grace J
AU  - Kim GJ
AD  - Department of Surgery, South Pointe Hospital Cleveland Clinic Foundation, 
      Warrensville Heights, USA.
FAU - Niehaus, Hannah
AU  - Niehaus H
AD  - Department of Surgery, South Pointe Hospital Cleveland Clinic Foundation, 
      Warrensville Heights, USA.
FAU - Conrad-Schnetz, Kristen
AU  - Conrad-Schnetz K
AD  - Department of Surgery, South Pointe Hospital Cleveland Clinic Foundation, 
      Warrensville Heights, USA.
LA  - eng
PT  - Case Reports
DEP - 20221115
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9754726
OTO - NOTNLM
OT  - clostridium ventriculi
OT  - emphysematous gastritis
OT  - gastric ischemia
OT  - gastric perforation
OT  - non-operative management
OT  - pneumatosis
OT  - sarcina ventriculi
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/12/22 06:00
MHDA- 2022/12/22 06:01
PMCR- 2022/11/15
CRDT- 2022/12/21 02:10
PHST- 2022/09/09 00:00 [received]
PHST- 2022/11/10 00:00 [accepted]
PHST- 2022/12/21 02:10 [entrez]
PHST- 2022/12/22 06:00 [pubmed]
PHST- 2022/12/22 06:01 [medline]
PHST- 2022/11/15 00:00 [pmc-release]
AID - 10.7759/cureus.31543 [doi]
PST - epublish
SO  - Cureus. 2022 Nov 15;14(11):e31543. doi: 10.7759/cureus.31543. eCollection 2022 
      Nov.