Gastric pneumatosis: An unexpected complication in multiple myeloma patient

Abstract

Gastric pneumatosis is an unusual and rare condition with unclear management recommendations. We report a case of gastric pneumatosis in an adult patient with multiple myeloma on chemotherapy with concomitant fungemia. Patient presented with right lower abdominal pain and subsequently developed spinal cord compression and got treated with high dose dexamethasone and chemotherapy. Patient developed upper GI symptoms and diagnostic imaging was ordered. A CT scan of the abdomen and pelvis was done which showed intramural gas in the gastric and esophageal wall along with positive blood cultures for candida krusei. Our patient was managed conservatively with antifungal, antibacterial therapy along with decompression via nasogastric tube but failed to improve. General surgery team recommended operative management, but the patient and family opted for comfort measures.