Emphysematous gastritis associated with gastric cancer: a rare and fatal entity

Emphysematous gastritis is a rare disease characterised by air in the wall of the stomach due to gas-forming microorganisms. This is a highly lethal entity for which only prompt diagnosis and treatment can avoid mortality. Different factors have been described that disrupt the integrity of the mucos...

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Bibliographic Details
Published in:BMJ case reports 2019-12, Vol.12 (12), p.e231796
Main Authors: Fonseca, Margarida Rodrigues, Constante, Mariana, Moura, Anne, Melo Valadão, Ivone
Format: Article
Language:English
Subjects:
Abdomen
Adenocarcinoma - complications
Adenocarcinoma - pathology
Adenocarcinoma - therapy
Aged, 80 and over
Alcohol abuse
Antibiotics
Blood
Case reports
Dementia
Diabetes
Emphysema
Emphysema - complications
Emphysema - diagnostic imaging
Endoscopy
Fatal Outcome
Female
gas/free gas
Gastric cancer
Gastritis - complications
Gastritis - diagnostic imaging
Humans
Infections
Literature reviews
Medical imaging
Mortality
Nutrition
Palliative Care
Pancreatitis - etiology
Parenteral nutrition
Parenteral Nutrition - adverse effects
Rare Disease
stomach and duodenum
Stomach Neoplasms - complications
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
Surgery
Tomography, X-Ray Computed
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Description
Summary:Emphysematous gastritis is a rare disease characterised by air in the wall of the stomach due to gas-forming microorganisms. This is a highly lethal entity for which only prompt diagnosis and treatment can avoid mortality. Different factors have been described that disrupt the integrity of the mucosa such as corrosive ingestion, alcohol abuse, recent abdominal surgery or cancer. We report a case of emphysematous gastritis in a 92-year-old woman who presented to the emergency department with abdominal pain, nausea and vomiting. Inflammatory markers were elevated and abdominal X-rays showed intramural gastric air, confirmed by CT scan. The patient received intravenous fluids, nutritional support and broad-spectrum antibiotic with resolution of gastric wall emphysema. However, the diagnosis of poorly cohesive gastric adenocarcinoma was made and the patient was referred to palliative care. This case highlights the importance of prompt recognition of this lethal entity that represents a rare and aggressive presentation of gastric cancer.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2019-231796