Nguyen Anna, Slader Mark, Spiegelman Lindsey
California University of Science and Medicine, Colton, CA.
University of California, Irvine, Department of Emergency Medicine, Orange, CA.
J Educ Teach Emerg Med. 2024 Apr 30;9(2):V10-V14. doi: 10.21980/J8ZH26. eCollection 2024 Apr.
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.
Gastric emphysema, emphysematous gastritis, gastric pneumatosis.
胃气肿（GE）和气肿性胃炎（EG）临床表现相似，但预后截然不同。虽然胃气肿通常为良性，但气肿性胃炎的死亡率高达60%。在此，我们报告一例29岁女性患者，她因恶心、呕吐和上腹部疼痛症状前往急诊科就诊。临床评估发现心动过速、疼痛程度与病情不符、白细胞增多和代谢性酸中毒。计算机断层扫描（CT）显示胃壁内有气体，初步诊断为胃气肿。患者对保守治疗反应良好，住院两天后出院。本病例报告强调医生需要熟练区分胃气肿和气肿性胃炎。及时识别和准确区分这两种情况有助于及时进行针对性治疗，最终改善患者的临床结局。通过深入了解这两种病理状况的病因、临床表现和影像学表现，我们旨在使临床医生能够做出明智的决策，为患者提供最佳治疗。
胃气肿、气肿性胃炎、胃壁积气
