Medical Management for Emphysematous Gastritis: Is It Time for a Standardized Approach?

Emphysematous gastritis (EG) is a rare form of gastritis with a high mortality rate caused by gas-forming organisms that infect the stomach wall. Due to the rarity of the condition, no established management guidelines exist. Historically, surgical exploration was favored, but more recently, the management has shifted to a non-surgical approach with antibiotics, gastric decompression, and bowel rest. Here, we detail the case of a 55-year-old male with EG in which medical management alone led to the complete resolution of his illness without complication. This case supports the efficacy of a medical management strategy for EG and highlights the duration of empiric antibiotics, the role for gastric decompression, bowel rest, and parenteral nutrition, and may guide a future standardized approach to treatment.