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Chen YA, Tsai HL, Liang PI, Wang JY. A rare case of Menetrier's disease-induced gastric outlet obstruction. Kaohsiung J Med Sci 2023; 39:1054-1055. [PMID: 37530671 DOI: 10.1002/kjm2.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/01/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Affiliation(s)
- Yi-An Chen
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hsiang-Lin Tsai
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Peir-In Liang
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
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Alcántara-Figueroa CE, Calderón-Cabrera DC, Pariona-Martínez YK, de la Cruz-Rojas R, Alcántara-Ascón RA. Ménétrier disease: A rare cause of hypertrophic gastropathy. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:435-436. [PMID: 37696684 DOI: 10.1016/j.rgmxen.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/03/2023] [Indexed: 09/13/2023]
Affiliation(s)
- C E Alcántara-Figueroa
- Escuela de Medicina, Universidad Privada Antenor Orrego, Trujillo, La Libertad, Peru; Servicio de Gastroenterología, Hospital Belén, Trujillo, La Libertad, Peru.
| | | | - Y K Pariona-Martínez
- Escuela de Administración, Universidad César Vallejo, Trujillo, La Libertad, Peru
| | - R de la Cruz-Rojas
- Escuela de Medicina, Universidad César Vallejo, Trujillo, La Libertad, Peru
| | - R A Alcántara-Ascón
- Escuela de Medicina, Universidad Privada Antenor Orrego, Trujillo, La Libertad, Peru
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Kmiecik M, Walczak A, Samborski P, Paszkowski J, Dobrowolska A, Karczewski J, Swora-Cwynar E. Upper gastrointestinal bleeding as an unusual manifestation of localized Ménétrier’s disease with an underlying lipoma: A case report. World J Gastrointest Endosc 2023; 15:10-18. [PMID: 36686066 PMCID: PMC9846829 DOI: 10.4253/wjge.v15.i1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/16/2022] [Accepted: 12/05/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Ménétrier’s disease is a rare condition characterized by enlarged gastric folds, usually located in the whole body and fundus of the stomach. This report presents an unusual case of localized Ménétrier’s disease elevated by a submucosal lipoma and thus looking like a polypoid mass and causing an episode of upper gastrointestinal bleeding. The mass was successfully removed with endoscopic submucosal dissection.
CASE SUMMARY Esophagogastroduodenoscopy was performed on a 76-year-old male patient after an episode of upper gastrointestinal bleeding, manifesting as fatigue and melena. A large polypoid mass (4 cm × 1 cm) with enlarged mucosal folds was found in the body of the stomach, between the lesser curvature and posterior wall. A small ulcer at the distal end of the mass was identified as the source of the bleeding. Biopsy was negative for neoplasia. Computed tomography showed a submucosal lesion beneath the affected mucosa, most likely a lipoma. The mass was removed en bloc with tunneling endoscopic submucosal dissection. Final pathology determined that the mass included Ménétrier’s disease and a submucosal lipoma. The patient was scheduled for follow-up esophagogastroduodenoscopy.
CONCLUSION Localized Ménétrier’s disease can coexist with a submucosal lipoma creating a polypoid mass with risk of bleeding.
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Affiliation(s)
- Michal Kmiecik
- Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Aleksandra Walczak
- Department of Clinical Pathology, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Pawel Samborski
- Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Jacek Paszkowski
- Department of General & Endocrine Surgery, and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Agnieszka Dobrowolska
- Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Jacek Karczewski
- Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
| | - Ewelina Swora-Cwynar
- Department of Gastroenterology, Nutrition and Internal Medicine, Poznan University of Medical Sciences, Poznan 60-355, Poland
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Ramrakhiani H, Triadafilopoulos G. Erasing Giant Folds: Ménétrier's Disease Treated with Cetuximab. Dig Dis Sci 2022; 67:5006-5009. [PMID: 36125594 DOI: 10.1007/s10620-022-07692-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 01/05/2023]
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Ramrakhiani H, Triadafilopoulos G. Erasing Giant Folds: Ménétrier's Disease Treated with Cetuximab. Dig Dis Sci 2022. [PMID: 36125594 DOI: 10.1007/s10621-021-07373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Kayes T, Bonnichsen M, Willmann L, Lorenzo A, Das A, El-Haddad C, Househ Z, Ng W, Ng W, Williams AJ, Prince D, Connor SJ. Menetrier’s disease exacerbating ulcerative colitis and relieved by gastrectomy. BMJ Open Gastroenterol 2021; 8:bmjgast-2021-000806. [PMID: 34930756 PMCID: PMC8689123 DOI: 10.1136/bmjgast-2021-000806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Ménétrier’s disease (MD) is a rare gastropathy characterised by giant rugal folds which can present with nausea, vomiting, abdominal pain and protein losing gastropathy. We report a 21-year-old woman with comorbid MD and ulcerative colitis (UC). Management was complicated by limited treatment options for MD, significant symptom burden, worsening nutrition and difficulty determining which disease was the predominant cause of symptoms. Since age 18 the patient experienced recurrent UC flares characterised by diarrhoea, persistent vomiting and corticosteroid dependence. Endoscopic assessment demonstrated concurrent MD and active UC. Octreotide and cetuximab were trialled given persistent hypoalbuminaemia and suspicion for MD associated protein-losing gastropathy. UC management comprised dose-optimised infliximab and methotrexate. Repeat endoscopic assessment demonstrated improvement in UC without corresponding improvement in symptoms or hypoalbuminaemia. Nasojejunal feeding and parenteral nutrition failed to significantly improve nutritional status and accordingly the patient proceeded to radical total gastrectomy. Postoperatively, MD-associated symptoms and hypoalbuminemia resolved completely.
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Affiliation(s)
- Tahrima Kayes
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Mark Bonnichsen
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Laura Willmann
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Aldenb Lorenzo
- Department of Upper GI surgery, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Amitabha Das
- Department of Upper GI surgery, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Carlos El-Haddad
- Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
- Department of Rheumatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Zaid Househ
- Department of Anatomical Pathology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Weng Ng
- Department of Medical Oncology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Watson Ng
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Astrid-Jane Williams
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - David Prince
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Susan J Connor
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Liverpool, New South Wales, Australia
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Wang HH, Zhao CC, Wang XL, Cheng ZN, Xie ZY. Menetrier’s disease and differential diagnosis: A case report. World J Clin Cases 2021; 9:6943-6949. [PMID: 34447846 PMCID: PMC8362536 DOI: 10.12998/wjcc.v9.i23.6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/06/2021] [Accepted: 07/02/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric mucosal hypertrophy, also known as Menetrier's disease (MD), is more common in men over 50 years of age, and the cause is unknown. The symptoms of the disease are atypical, mostly accompanied by hypoproteinemia and edema, and sometimes accompanied by symptoms such as epigastric pain, weight loss, and diarrhea. Most experts believe that the site of the disease is mainly located in the fundus of the stomach and the body of the stomach. We found that the site of the disease in this patient involved the antrum of the stomach.
CASE SUMMARY We introduced the case of a 24-year-old woman who had repeated vomiting for 5 d and was admitted to our hospital. After various examinations such as computed tomography and pathology in our hospital, the final diagnosis of the presented case is MD. The salient feature is that the mucosal folds in the fundus and body of the stomach are huge and present in the shape of gyrus. The greater curvature is more prominent, and there are multiple erosions or ulcers on the folds. The patient did not undergo gastric surgery and did not undergo re-examination. She is drinking Chinese medicine for treatment, and her vomiting and abdominal pain symptoms have improved. This disease is relatively rare in clinical practice, and it is easy to be misdiagnosed as gastric cancer, chronic gastritis and gastric lymphoma, etc.
CONCLUSION MD can occur in the antrum, it is necessary to raise awareness of the disease and reduce misdiagnosis.
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Affiliation(s)
- Hou-Hong Wang
- Department of Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Can-Can Zhao
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Xiao-Lei Wang
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Ze-Nong Cheng
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
- Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
| | - Zong-Yu Xie
- Department of Radiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China
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Crafa P, Franceschi M, Franzoni L, Di Mario F. Abnormal Levels of Pepsinogen I and Gastrin 17 in a case of Ménétrier Disease. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021207. [PMID: 34212902 PMCID: PMC8343745 DOI: 10.23750/abm.v92i3.11592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM We describe a case of Ménétrier disease, occurred in female patient. METHODS We decide to assess by non-invasive way (serum pepsinogens and gastrin 17) the secretory status of gastric mucosa, to confirm previous data of the literature, claiming high levels of both acid secretion and hypergastrinemia in this rare pathological condition. RESULTS AND CONCLUSION We find in the subject the highest values of pepsinogen 1 - a marker of acid secretion - never described in the literature to our knowledge: 1940 mcg/L, being normal values ranging from 30-160 mcg/L. Similarly, gastrin 17, produced 90% in the antrum and responsible for negative acid feedback, was very high: 139 pg/L, ranging normal values between 1-10 pg/L. (www.actabiomedica.it).
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Affiliation(s)
| | - Marilisa Franceschi
- Department of Medicine, ULSS7 Pedemontana, Hospital AltoVicentino, Santorso (VI).
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Waisberg DR, de Mello ES, Tustumi F, Szor DJ, Charruf AZ, Fuhro FE, Waisberg J, Dias AR. A case report of diffuse hyperplastic gastropathy with multiple polypoid formations in a patient with pernicious anemia, Helicobacter pylori infection, hypergastrinemia and hypoalbuminaemia: Do not forget of Ménétrier's disease. Int J Surg Case Rep 2020; 77:498-502. [PMID: 33395833 PMCID: PMC7700994 DOI: 10.1016/j.ijscr.2020.11.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Ménétrier's disease is a rare condition, frequently associated with Helicobacter pylori infection, hypergastrinemia and hypoalbuminaemia. PRESENTATION OF THE CASE A case of a 55 years-old female patient with a previous diagnosis of pernicious anemia complaining of epigastric discomfort, hyporexia, vomiting, and weight loss is reported. Endoscopy showed multiple gastric polyploid formations and Helicobacter pylori infection was detected. Laboratory tests showed elevated gastrin serum levels and presence of antibodies antiparietal cells, as well as microcytic hypochromic anemia compatible with chronic iron deficiency. Albumin serum level was slightly decreased. Full thickness biopsy performed via echoendoscopy reported gastritis cystica/polyposa profunda. Given the association of diffuse involvement of the entire stomach, the possibility of developing malignant disease and the clinical symptoms, the patient underwent laparoscopic total gastrectomy with Roux-en-Y reconstruction. The surgical specimen showed the mucosa hyperemic and swollen, with prominent gastric folds. Hyperplastic elongation of gastric foveolas associated with disappearance of oxyntic glands was compatible with Ménétrier's disease. DISCUSSION The Ménétrier's disease diagnosis may be tricky, especially when an unusual endoscopic presentation is associated with other conditions that may mislead the diagnostic evaluation. The differential diagnoses were gastric malignancies, Zollinger-Ellison syndrome, massive gastric polyposis and gastritis cystica/polyposa profunda. CONCLUSION Clinical, laboratory, endoscopic and histopathological findings are paramount for reaching the diagnosis of Ménétrier's disease, but it should be suspected in all cases of upper gastrointestinal symptoms and hypertrophied gastric mucosa.
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Affiliation(s)
- Daniel Reis Waisberg
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil
| | | | - Francisco Tustumi
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil.
| | - Daniel José Szor
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil
| | - Amir Zeide Charruf
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil
| | - Felipe Emanuel Fuhro
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil
| | - Jaques Waisberg
- Digestive and General Surgery Department, ABC Medical School (FMABC), Santo Andre, Brazil
| | - André Roncon Dias
- Department of Surgery, Hospital de Clínicas Municipal José Alencar, Sao Bernardo do Campo, Brazil
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