Conservative Management of Suspected Emphysematous Gastritis

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Mackay, Thomas G
Phan, Du H
Mantha, Pranay S
Ibrahim, Hany S
Burstow, Matthew J
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2022
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Abstract

Emphysematous gastritis is a rare surgical condition. Although there is a lack of a common definition, the key features of its presentation include gastric emphysema on imaging and the presence of gas-forming organisms in the gastric mucosa. In this study, we report the case of an 80-year-old Caucasian male who presented with abdominal pain; a computed tomography scan demonstrated gastric emphysema (intra-mural air within the stomach). After upper gastrointestinal endoscopy excluded gross perforation, ulcer, and malignancy, the patient recovered to baseline with conservative management consisting of gastric rest (nil by mouth and nasogastric tube decompression), intravenous antibiotics, and intravenous proton pump inhibitor. Given the wide pathogenic mechanisms for gastric emphysema, we recommend a conservative but cautious approach if the patient does not demonstrate clinical features of hemodynamic instability, sepsis, and peritonitis.

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Cureus

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14

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11

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© Copyright 2022 Mackay et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Subject

Gastroenterology and hepatology

conservative vs surgical management

emphysematous gastritis

gastric emphysema

gastric pneumatosis

gastritis

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Mackay, TG; Phan, DH; Mantha, PS; Ibrahim, HS; Burstow, MJ, Conservative Management of Suspected Emphysematous Gastritis., Cureus, 2022, 14 (11), e31995

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