Gastric Emphysema a Spectrum of Pneumatosis Intestinalis: A Case Report and Literature Review

Abstract

The finding of gas within the gastric wall is not a disease by itself, rather than a sign of an underlying condition which could be systemic or gastric. We present the case of a woman identified with gastric emphysema secondary to the administration of high doses of steroids, with the purpose of differentiating emphysematous gastritis versus gastric emphysema due to the divergent prognostic implications. Gastric emphysema entails a more benign course, opposed to emphysematous gastritis which often presents as an acute abdomen and carries a worse prognosis. Owing to the lack of established diagnostic criteria, computed tomography is the assessment method of choice. Currently no guidelines are available for the management of this entity, since the evidence is limited to a few case series and a considerable number of single case reports.

Gastric emphysema secondary to severe vomiting: a comparative review of 14 cases

“…Minor causes include air leakage from the alveoli or mediastinum in obstructive lung disorders or pneumothorax; gastric dilation in eating disorders like bulimia or anorexia nervosa; blunt abdominal trauma; cardiopulmonary resuscitation; connective tissue disorders; diabetic gastroparesis; ingested toxins; pancreatitis; and/or cytotoxicity of chemotherapeutic agents such as cyclophosphamide, adriamycin, vincristine and high-dose dexamethasone 5–7. There are numerous risk factors for gastric emphysema, including gastric ischaemia, aberrant arterial anatomy, atherosclerosis, hypertension, dyslipidaemia, weakened gastric wall due to connective tissue disorders, asthma, alcoholism, pancreatitis and diabetes mellitus 7. In the present case, gastric emphysema was attributed to severe vomiting.…”

Conservative management of gastric emphysema with hepatoportal venous gas

“…Gastric pneumatosis may represent benign gastric emphysema (GE), which resolves spontaneously, or emphysematous gastritis, which has a high mortality 1. While this patient's history of active substance abuse and evidence of HPVG were concerning for emphysematous gastritis, his haemodynamic stability and rapid symptomatic resolution was more consistent with a viral gastroenteritis 2.…”

Gastric Pneumatosis: Emphysematous Gastritis versus Gastric Emphysema

“…Air in the wall of the stomach is called gastric pneumatosis, which is a rare finding and may be associated with a benign condition like gastric emphysema (GE) to life threatening condition emphysematous gastritis (EG). 1 We present a case of a diabetic patient who developed EG following abdominal surgery and managed conservatively with favorable outcome.…”