Emphysematous gastritis: a case report

Emphysematous gastritis (EG) is a rare disease entity related to infection of the gastric wall. It is caused by gas-forming pathogens including Enterobacter species, Clostridium perfringens and others. EG patients clinically present with symptoms similar to acute abdomen and can have a mortality that can reach up to 80%. Alcoholism was identified as a risk factor for such a disease. Different diseases like diabetes mellitus, ulcerative colitis and use of nonsteroidal anti-inflammatory agents were found to be associated with EG. To date, no clear guidelines regarding EG management, however, early detection and management is crucial to prevent related deaths. In the acute setting, the role of surgery is limited. Surgical interventions might be needed if obstruction of gastric outlet or perforation ensues. Fifty six years old male, heavy smoker, alcoholic with a history of ischemic heart disease, presented to Emergency Department with a complaint of severe epigastric abdominal pain for two days. The patient was vitally stable, conscious, oriented, however, looks in severe pain. His lab investigations were within normal ranges. Computed tomography (CT) of the abdomen was consistent with emphysematous gastritis. To our knowledge, this is the first case of emphysematous gastritis reported in Saudi Arabia using only radiological modality.