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Emphysematous gastritis with delayed gastric perforation
Blair A Wormer1, Gamal Mostafa
1Department of General Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC 28203, USA. blair.wormer@carolinas.org
Summary
Emphysematous gastritis (EG), a rare stomach infection, can lead to gastric perforation. This case shows that even with perforation, non-surgical management can be successful, challenging the need for immediate surgery.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Emphysematous gastritis (EG) is a rare, severe gastric infection caused by gas-producing microorganisms.
- It is associated with high mortality and typically requires surgical intervention only for sepsis or perforation.
Observation:
- A 24-year-old female with uncontrolled diabetes presented with vomiting and hyperglycemia.
- Computed tomography revealed gas in the stomach wall and portal venous system, diagnosing EG.
- The patient developed contained gastric perforation during treatment.
Findings:
- Prompt diagnosis and conservative management (antibiotics, bowel rest, observation) were initiated.
- The patient's contained gastric perforation was successfully managed without surgical intervention.
- This case highlights a potential non-surgical treatment pathway for EG complications.
Implications:
- Delayed gastric perforation in EG may be managed non-surgically in select cases.
- Gastric perforation is not always an absolute indication for surgery in emphysematous gastritis.
- This finding could alter clinical decision-making for this rare condition.
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Clinical Manifestations:
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