A case of chronic ischemic erosive gastropathy healed after surgical revascularization

A case of chronic ischemic erosive gastropathy secondary to chronic abdominal vascular insufficiency is reported. This gastropathy healed after revascularization procedure but then recurred after stenosis of the aortomesenteric graft. The clinical picture was characterized by post-prandial abdominal pain, weight loss and an abdominal bruit. The upper gastrointestinal endoscopy showed multiple non hemorrhagic antral erosions with irregular outlines and a pseudomembranous floor. Reduction of the resistance of the gastric mucosal barrier by a chronic decrease of mucosal blood flow probably accounted for the gastric erosions. Although the prevalence is unknown, ischemic injury to the stomach is unexpected, because of the rich collateral circulation of this organ. Increased awareness of the disease and its prognostic implications should lead to suggest abdominal vascular insufficiency based on their clinical and gastroscopic aspects, thus leading to operation before acute mesenteric infarction occurs.