Abstract
Emphysematous gastritis is a rare form of phlegmonous gastritis which can occur secondary to debilitation, systemic infections, malnutrition, endoscopic polypectomy, gastric malignancy, ingestion of corrosives. Rapid diagnosis and treatment is imperative since this condition has a high mortality rate. In most cases medical therapy alone is not suffcient for cure, therefore patients may require local gastric resection or total gastrectomy. A 69 year old black female with a history of recent intraabdominal surgery(colonic mass excised,colostomy, oopherectomy, omenectomy)presented to the emergency room with a two day history of nausea, vomiting, fever, epigastric pain. She denied hemeiemesis, melena, bloating. The patient subsequently had abdominal films(CT of abdomen and pelvis, plain films) which did reveal thickening of the stomach wall, gas in the stomach wall, air within the portal vein. Subsequently, she was treated with broad spectrum antibiotics and proton pump inhibitor for ten days. Clinical improvement was evident after five days of medical treatment. Radiologic improvement was evident with complete resolution of air within the stomach wall, and portal vein after ten days of medical treatment. Emphysematous gastritis carries a high mortality rate, which requires both medical and surgical intervention to reduce mortality to twenty percent. This case illustrates that medical treatment alone can successfully treat this rare entity if diagnosis and treatment are instituted early on in the course of this disease.