ArticleJournal of surgical case reports2026
Emphysematous gastritis with portal venous gas: conservative management in a high-risk patient.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Emphysematous gastritis is a rare, often fatal condition characterized by gas within the gastric wall, usually in patients with significant comorbidities. We describe a 75-year-old man with incomplete tetraparesis, chronic respiratory failure and type 2 diabetes who presented with abdominal pain, vomiting and hematemesis. Initial computed tomography (CT) was reported as non-obstructive small-bowel dilatation with possible gallstone ileus, but subspecialty radiology review identified intramural gastric gas with portal venous gas consistent with emphysematous gastritis. He was managed non-operatively with nasogastric decompression, intravenous broad-spectrum antibiotics and proton-pump inhibition within a ward-based ceiling of care. Repeat CT on day 10 showed complete radiological resolution. Despite this, he later developed sepsis from a large necrotic pressure ulcer and died after a multidisciplinary decision for palliative care. This case supports conservative management in selected high-risk patients and emphasizes early, meticulous pressure-area assessment in immobile surgical admissions.
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