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A Case Report Evaluating Gastric Emphysema versus Emphysematous Gastritis

Anna Nguyen*, Mark Slader, MD ^, Lindsey Spiegelman, MD, MBA^

*California University of Science and Medicine, Colton, CA
^University of California, Irvine, Department of Emergency Medicine, Orange, CA

Correspondence should be addressed to Lindsey Spiegelman, MD, MBA at lspiegel@hs.uci.edu

DOI: https://doi.org/10.21980/J8ZH26Issue 9:2
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Gastric Emphysema. Axial CT annotated. JETem 2024
Gastric Emphysema. Coronal CT annotated. JETem 2024
Gastric Emphysema. Sagital CT annotated. JETem 2024

ABSTRACT:

Gastric emphysema (GE) and emphysematous gastritis (EG) share similar clinical presentations but exhibit drastically different prognoses. While GE is generally benign, EG is associated with mortality rates up to 60%. Here, we present the case of a 29-year-old female patient who presented to the emergency department (ED) with symptoms of nausea, vomiting, and epigastric abdominal pain. Clinical evaluation revealed tachycardia, pain out of proportion, leukocytosis, and metabolic acidosis. Computed tomography (CT) scan unveiled the presence of air within the gastric wall, and a presumptive diagnosis of gastric emphysema was made. The patient responded positively to conservative management and was discharged after a two-day hospitalization. This case report emphasizes the need for physicians to adeptly distinguish between GE and EG. Timely identification and precise differentiation of the two conditions allow for timely and tailored management, ultimately leading to improved clinical outcomes in patients. By providing insights into the etiologies, clinical presentations, and imaging findings for the two pathologies, we aim to empower clinicians to make informed decisions for optimal patient care.

Topics:

Gastric emphysema, emphysematous gastritis, gastric pneumatosis.

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