Gastric emphysema following drug-induced gastritis

Abstract

A case of intramural air in the stomach with pneumoperitoneum due to gastric emphysema which was managed conservatively is presented. Case reportA 55-year-old man presented as an emergency with a 10-day history of pain in the upper abdomen with distension, vomiting and hiccoughs. He had suffered from gouty arthritis for 25 years and from mild diet-controlled diabetes mellitus. The patient was taking non-steroidal anti-inflammatory drugs for a recent exacerbation of arthritis.O n examination there was tachycardia, fullness in the epigastrium and tenderness in the upper abdomen. Laboratory investigation showed leucocytosis (white cell count 12 x 109/litre) and a blood glucose level of 13.75 mmol/l. A nasogastric tube was passed and approximately 2 litres of haemorrhagic aspirate was obtained, which completely relieved the distension and pain. The abdomen became soft and non-tender.

Emphysematous Gastritis - Case Report and Review of the Literature

“…The stomach wall is well protected from bacterial infection by the close connection between cells, an acid pH and a good blood supply. Factors damaging these protective mechanisms are the ingestion of corrosives, bases and acids [11,12], overindulgence in alcohol [13], recent abdominal surgery, gastroenteritis and treatment with non-steroidal analgo-antirheumatics -NSAR [3,13,14]. In the literature we have also found cases of emphysematous gastritis developing in connection with other chronic diseases.…”

The predictors of mortality and secular changes in management strategies in emphysematous gastritis

“…Common triggers include the ingestion of corrosives [4,5], alcohol abuse [6], recent surgery, gastroenteritis, and non-steroidal antiinflammatory drug (NSAID) usage [6][7][8] The predictors of mortality in emphysematous gastritis 5 epigastric abdominal pain, nausea, vomiting, and diarrhea with signs of hemodynamic instability and leukocytosis. Some patients also develop melena and hematemesis.…”

Gastric pneumatosis and hepatic portal venous gas after blunt trauma does not mandate surgery

“…1,2,12,10,4 The severity of gastric emphysema seems to be related to the offending process, demanding either conservative treatment 1,4 or surgery. 10,12 To our knowledge only two case reports of GP after blunt trauma have been published previously.…”