Surviving emphysematous gastritis after hepatectomy

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Oncology

Background:

• Emphysematous gastritis is a rare, life-threatening variant of phlegmonous gastritis.
• It involves gas-forming bacteria invading the stomach wall, leading to sepsis.
• Underlying pathologies often predispose patients to this condition.

Purpose of the Study:

• To report a case of emphysematous gastritis in a patient with hepatocellular carcinoma post-hepatectomy.
• To review the literature on the pathology, clinical features, and management of emphysematous gastritis.

Main Methods:

• Case report of a middle-aged male with hepatitis B virus-related hepatocellular carcinoma.
• Diagnosis confirmed by imaging showing gas in the stomach wall.
• Management included emergency laparotomy, upper endoscopy, and antibiotic therapy.

Main Results:

• The patient developed emphysematous gastritis 4 days after partial hepatectomy.
• Successful treatment with antibiotics and surgical intervention.
• Recovery and discharge 18 days after the second operation.

Conclusions:

• Emphysematous gastritis is a critical surgical emergency requiring swift diagnosis and treatment.
• Early recognition and management are key to patient survival, especially in immunocompromised individuals.
• This case underscores the importance of considering rare complications in post-operative patients with significant comorbidities.