Gastric emphysema demonstrated by computed tomography

Gas in the wall of the stomach is a rare occurrence which can be well demonstrated radiologically. The nomenclature of intramural gastric gas has been confusing, despite a reasoned approach to its classification, proposed initially over 20 years ago (Keyting et al, 1961) and recently emphasised (Kussin et al, 1982; Kowal et al, 1982; Lee & Rutledge, 1984). The purpose of the present report is to describe a case of gastric emphysema demonstrated by computed tomography (CT) and to reinforce the current classification based on aetiology. A 74-year-old man was admitted with a 2-week history of vomiting and a 1-week history of progressively deepening jaundice. He had lost more than 10 kg in weight. He had been in good health previously and there was no relevant past medical history. On examination he was jaundiced and there was 4 cm smooth, tender hepatomegaly. No other abnormality was present. There was no succussion splash. Initial investigations showed a hypochloraemic, hypokalaemic alkalosis. The blood ure...