H. pylori Gastritis Presenting as
  Multiple Black Macules in the Gastric Antrum

Tharani Sundararajan; Sheng Chen; Madhusudhanan Jegadeesan; Ramprasad Jegadeesan

doi:10.37421/cgj.2021.6.141

Image Article - (2021) Volume 6, Issue 4

H. pylori Gastritis Presenting as Multiple Black Macules in the Gastric Antrum

Tharani Sundararajan¹, Sheng Chen², Madhusudhanan Jegadeesan³ and Ramprasad Jegadeesan⁴^*

^*Correspondence: Ramprasad Jegadeesan, Department of Gastroenterology, SIU School of Medicine, Springfield, IL, United States, Email:

Author information

¹Department of Internal medicine, SIU School of Medicine, Springfield, Illinois, United States
²Department of Pathology, Memorial Medical Center, Springfield, Illinois, United States
³Department of Surgical Gastroenterology, Apollo Specialty Hospitals, Tamil Nadu, India
⁴Department of Gastroenterology, SIU School of Medicine, Springfield, IL, United States

Received: 02-Mar-2021 Published: 23-Mar-2021 , DOI: 10.37421/cgj.2021.6.141
Citation: Sundararajan, Tharani, Sheng Chen, Madhusudhanan Jegadeesan and Ramprasad Jegadeesan . “H. pylori Gastritis Presenting as Multiple Black Macules in the Gastric Antrum”. Clin Gastro J 6(2021):141
Copyright: © 2021 Sundararajan T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

About the Study

A 59-year-old male with past medical history of asthma, hypertension, type 2 diabetes mellitus, hyperlipidemia and coronary artery disease presented with complaints of intermittent epigastric pain, nausea and vomiting for past four months. CT of abdomen and pelvis showed moderate circumferential thickening in segments of mid small bowel and thickening of the lower esophagus. He underwent push enteroscopy which showed multiple 2-8 mm black macular lesions in the gastric antrum (red arrow in Figures 1 and 2) along with normal appearing small bowel and esophagus. Biopsies of the black macular lesions revealed evidence of H. pylori gastritis along with surface erosion and mild gastric atrophy (red arrow in Figure 3) and were negative for melanoma, iron deposition or melanin deposition. Small bowel biopsies were normal. H. pylori infection causes peptic ulcer disease, acute and chronic gastritis, atrophic gastritis, usually with gastric intestinal metaplasia and dysplasia, and gastric cancer, especially intestinal-type [1,2].

Figure 1. Multiple black macular lesions in the stomach (red arrows).

Figure 2. A large black macular lesion in the gastric antrum (red arrows).

Figure 3. Evidence of H. pylori causing surface erosion (red arrows).

Informed Consent

Informed consent was obtained from the patient to submit the images.

Conflict of Interest Disclosure

Guarantor of the article

Ramprasad Jegadeesan will be the guarantor of the submitted image. He has access to and control of the images submitted.

Specific author contributions

Tharani Sundararajan: Author contributed in literature review, image collection and associated case information, drafting the manuscript. The author has revised and agree with the final image manuscript sub mitted.

Sheng Chen: Author has contributed in pathology image collection, review of the pathology slide. Author has critically revised and approved the image article for submission.

Madhusudhanan Jegadeesan: Author has contributed in image manuscript draft revision and he has approved the final manuscript submitted.

Ramprasad Jegadeesan: Author contributed in the planning of the image article. He revised and approved the final image manuscript prior to submission.