Gastric Candidiasis Leading to Gastric Perforation: A Case Report
Published: October 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/65582.18623
Mareedu Sri Hari Rao, Himanish Sen, Mareedu Radhika Rani, Mareedu Suhas
1. Professor, Department of General Surgery, Osmania Medical College, Hyderabad, Telangana, India.
2. Junior Resident, Department of General Surgery, Osmania Medical College, Hyderabad, Telangana, India.
3. Associate Professor, Department of Radiotherapy, MNJ Cancer Hospital, Hyderabad, Telangana, India.
4. Medical Student, All American Institute of Medical Sciences, Black River, St. Elizabeth, Jamaica.
Correspondence
Himanish Sen,
c/o Dr. M Sri Hari Rao, Flat C-123, Krishna Apartments, 8-3-324, Yellareddy Guda, Ameerpet, Hyderabad-500073, Telangana, India.
E-mail: senhimanish@gmail.com
Gastric candidiasis is commonly seen in immunocompromised patients with malignant conditions and patients who have undergone gastrectomy. It is also observed in patients who frequently use antacids. The most common presentation of gastric candidiasis is single or multiple ulcerations, with perforation being an infrequent occurrence. The present case report describes a 38-year-old male with a known history of peptic ulcer disease, who presented with abdominal pain and shortness of breath for the past two days. The patient had been using antacids and Proton Pump Inhibitors (PPIs) for two years. Chest and abdomen radiographs revealed an air shadow under the right diaphragm. Emergency surgery was performed, revealing two stomach perforations. The patient underwent primary repair and a Modified Graham’s patch repair. Histological examination of the perforation margin showed invasive candidal colonisation. The patient experienced a series of postoperative complications during their hospital stay, all of which were successfully managed. The patient was discharged on the 40th postoperative day. Therefore, it was concluded in this case that the chronic use of antacids and PPIs may have created an alkaline environment, facilitating candidal colonisation of the stomach, ultimately leading to ulceration and perforation.
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