Emphysematous Gastritis - Case Report and Review of the Literature

Abstract

Emphysematous gastritis is a rare form of phlegmonous gastritis caused by invasion of the stomach wall by gas-forming bacteria. This clinical entity was first described by Fraenkel in 1889. The authors report the case of a 58-year-old patient with end-stage renal failure under treatment with hemodialysis for the past year. He was admitted on account of pain in the lower abdomen. During the diagnostic procedure, emphysematous gastritis and acute cholecystitis were confirmed. An acute abdomen developed and an emergency laparotomy was performed. During the procedure, the necrotic gallbladder was removed. The patient died on the following day due to multiorgan failure and septic shock. According to the literature, emphysematous gastritis is generally a fatal disease. Air in the wall of the stomach is a rare finding with a broad differential diagnosis.

Successful Conservative Treatment of Emphysematous Gastritis

“…No consensus exists as to the optimal treatment strategy, although a small number of studies have reported successful results with conservative treatment in recent years (7,8,12,13). These reports focused on the use of broad-spectrum antibiotics, bowel rest and nutritional management.…”

Emphysematous gastritis after bone marrow transplant: Successful conservative management

“…Despite immunosuppression and multi-organ failure, our patient recovered with standard medical management. Some patients with similar co-morbidity have not survived similar management in the past [11][12][13]. Surgical intervention has been successful for cases of EG complicated by gastric or intestinal perforation, ischemia, and unsuccessful medical management [4,14,15].…”

Phlegmonous Gastritis in a 32-Week Pregnant Woman Managed by Conservative Surgical Treatment and Antibiotics

“…Phlegmonous gastritis is an acute infection of the stomach wall by pyogenic bacteria [1][2][3]. This clinical entity was first illustrated by Verandeaens in 1617 and then described in 1862 by Cruveilhier [3].…”

“…Phlegmonous gastritis is an acute and unusual infection of the stomach wall by pyogenic bacteria [1][2][3]. This pathologic condition is extremely rare and associated with a poor prognosis [1][2][3][4][5][6][7].…”

“…This pathologic condition is extremely rare and associated with a poor prognosis [1][2][3][4][5][6][7]. The usual fulminating course of the dis-S. Hommel · G. Savoye ( ) · C. Lorenceau-Savale · E. Lerebours Département d'hépatogastroenterologie et nutrition, Hôpital C Nicolle, 1 Rue de Germont, 76031 Rouen Cedex, France e-mail: g savoye@hotmail.com or guillaume.savoye@chu-rouen.fr B. Costaglioli Service de chirurgie digestive, Hôpital C Nicolle, Rouen, France F. Baron Département d'obstétrique, Hôpital C Nicolle, Rouen, France F. Le Pessot · F. Lemoine Laboratoire d'anatomopathologie, Hôpital C Nicolle, Rouen, France ease makes it difficult to establish a lifetime diagnosis and phlegmonous gastritis is often recognize post mortem [1,7].…”