Back to 2025 Posters
A RARE ENCOUNTER: EMPHYSEMATOUS GASTRITIS IN FOCUS
Sanitha Pulapattassery
*, Adam Gold, Mohankumar Doraiswamy
Internal Medicine, Mercy Hospital Fort Smith, Fort Smith, AR
Emphysematous Gastritis (EG) is a life-threatening form of gastritis caused by gas forming organisms such as Escherichia coli, Streptococcus, Enterobacter, and Clostridium species. According to Watson et. al review, only 59 cases have been documented in the English literature, and there are currently no established guidelines for managing emphysematous gastritis. We describe a case of a 70 year old man who presented with hematemesis and was diagnosed with EG based on clinical and radiological findings. Computerized Tomography (CT) is the preferred imaging modality for diagnosis.
A 70-year-old man presented to the emergency room from his nursing home with hematemesis of one day duration. The patient had no history of gastrointestinal bleeding, alcohol use, abdominal surgeries, or high dose steroid use. Denies diarrhea and abdominal pain. Past medical history is significant for advanced dementia due to Parkinson's disease. Vitals including blood pressure, heart rate, respiratory rate and temperature were within normal limits. On physical examination, mucous membranes were dry with no abdominal or distention or tenderness. Labs were unremarkable except for leukocytosis. CT abdomen pelvis revealed prominent gastric distension with concern for possible emphysematous gastritis with extensive portal venous air with also air in mesenteric vessels and a small amount of pneumoperitoneum. The patient’s family declined aggressive treatment and opted for hospice. Unfortunately, the patient passed away the following day.
EG is a severe type of gastritis that can quickly progress to necrosis, perforation, and sepsis. The rarity of EG and the limited number of cases described in literature pose significant challenges for clinicians in accurately diagnosing and effectively managing this condition. This case highlights the importance of early diagnosis and management due to its high morbidity and mortality rate. It contributes to the scare documentation of this rare condition enriching the existing literature and providing valuable insights that may aid in its early diagnosis.
Gastric Wall Gas
Portal Venous Gas
Back to 2025 Posters
