Abstract
A 40-year-old male patient was referred to our hospital with compalints of poor appetite, epigastralgia, and a body weight-loss during past one month.
X-ray examinations proved an irregular contour and stiffness of the distal part of the stomach. Several ulcerative lesions were also revealed mainly in the pyloric antrum. Gastric endoscopy showed multiple ulcers with irregular shapes and nodular mucosal changes spreading from the lower body to the pyloric antrum. Those findings suggested a possible gastric cancer of Borrmann type 4. However, no evidence of malignancy was obtained from biopsy specimens.
Serological test for syphilis resulted in strongly positive, and history taking in detail revealed that he had had a chance of syphilitic infection about 2 months ago.
Those facts finally indicated gastric syphilis, and a diagnostic anti-leutic treatment using AMPC was started. The treatment recovered his appetite in 2 weeks. The X-ray and endoscopic examinations proved marked improvement of the gastric lesions in about a month.
Final diangosis of gastric syphilis was confirmed from the efficacy of the diagnostic treatment with AMPC, although Treponema pallidum was not disclosed in any biopsy specimens.
Reports of gastric syphilis for the past 10 years in Japan are reviewed on the aspect of diagnosis.
