Open AccessSarcina ventriculi: A Rare Case of Life-Threatening Perforated Gastric Ulcer and Review of Literature
Author(s) -
Qing Wei,
Sixto M. Leal,
Morad Qarmali,
C. Mel Wilcox,
Chirag Patel,
Sameer Al Diffalha
Publication year - 2020
Publication title -
journal of gastric surgery
Language(s) - English
Resource type - Journals
eISSN - 2704-9108
pISSN - 2704-8284
DOI - 10.36159/jgs.v2i2.36
Subject(s) - medicine , perforation , sarcina , gastroenterology , gastritis , stomach , helicobacter pylori , surgery , materials science , genetics , biology , bacteria , punching , metallurgy
Sarcina ventriculi is a gram-positive anaerobic bacterium reported rarely in patients with a history of gastrointestinal surgery and delayed gastric emptying. Sarcina has been implicated in the development of gastric ulcers, emphysematous gastritis, and gastric perforation. So far, less than 30 cases of Sarcina isolated from gastric specimens have been reported, including 3 cases associated with life-threatening illness: emphysematous gastritis and gastric perforation. Herein, we report a case of a 58-yearold woman with history of gastric surgery who presented for evaluation of persistent gastric pain and incurable ulcer. She underwent total gastrectomy, and the resected stomach demonstrated a perforated ulcer with the presence of Sarcina microorganisms. We also report a second case of a 56-year-old woman with history of NSAID use who presented with gastric outlet obstruction. The gastric biopsy identifi ed concurrent Helicobacter pylori and Sarcina. Given Sarcina‘s association with emphysematous gastritis and gastric perforation, its identifi cation on gastric biopsies should be clearly stated in pathology reports and, depending on the clinical scenario, prompt clinicians to add adjunctive antimicrobials to anti-ulcer therapeutic regimens.