“…In this case, the patient developed complications like perforation, so surgical management is compulsory. The differential diagnosis for this condition should be distinguished from gastric emphysema, which is brought on by mechanical forces, including nasogastric (NG) tube insertion, emesis, alveolar leaks in COPD, chemotherapy-induced mucosal ischemia, pseudomonas infection, and appearance of a round gas bubble on radiographic imaging [ 6 ]. This condition also resembles cystic pneumatosis/cystic emphysema, in which the stomach wall will have many 1-2 mm gas-filled cysts.…”