Elnaggar Mohamed, Abbas Omar F, Haddad Roaa, Helal Mohamed Mohsen, AbouShawareb Hala, Abouelmagd Alaa Abdrabou, Almarfadi Abdullah, Amer Ahmed Galal, Hussein Yousif Ahmad Hanafi, Ayoub Motasem, Ebrahim Mohamed Ayman, Aldemerdash Mohamed A, Elkhattib Ismail, Ghallab Mohamed, Eltaly Hatem, Abd El Aziz Mohamed, Parikh Neil
Hospital Medicine department, Hartford Hospital, Hartford, CT, USA.
Faculty of Medicine, Al-Azhar university, Cairo, Egypt.
Clin Res Hepatol Gastroenterol. 2025 Jul-Aug;49(7):102638. doi: 10.1016/j.clinre.2025.102638. Epub 2025 Jun 16.
Emphysematous Gastritis is a rare condition, characterized by the presence of gas within the gastric wall. It is associated with a high mortality rate, but early diagnosis and treatment can significantly reduce mortality and improve patient outcomes.
For this systematic review, we searched PubMed, Scopus, Web of Science, and Embase from inception until October 2024 to find relevant case reports or case series on emphysematous gastritis.
A 116 case report and case series revealed that patient ages ranged from 4 months to 96 years (mean age: 55), male (55 %). Most cases were reported in Asia and the USA. The majority of symptoms were 90 % abdominal pain, and 80 % vomiting and nausea. Infection of the gastric wall by gas-forming organisms was commonly Sarcina ventriculi. Abdominal CT scans identified emphysematous changes in 95 % of cases. Endoscopic examinations revealed Gastric Mucosal Erythema in 80 % of patients, with elevated leukocytosis in 80 % of cases. The majority of the recovery rate was 70 %, and the mortality rate was 15 %; (75 % received medical treatment,25 % surgical treatment), and 79 % were given medical treatment including antibiotics and supportive care while in severe cases 21 % were surgical.
Emphysematous Gastritis requires a multidisciplinary approach for optimal outcomes. CT imaging remains pivotal for diagnosis, and management should be individualized based on disease severity and patient factors. While mortality remains significant, early recognition and advancements in medical care have improved survival in many cases.
气肿性胃炎是一种罕见疾病，其特征是胃壁内存在气体。它与高死亡率相关，但早期诊断和治疗可显著降低死亡率并改善患者预后。
对于本系统评价，我们检索了从创刊至2024年10月的PubMed、Scopus、科学网和Embase，以查找有关气肿性胃炎的相关病例报告或病例系列。
116篇病例报告和病例系列显示，患者年龄从4个月至96岁不等（平均年龄：55岁），男性占55%。大多数病例报告来自亚洲和美国。大多数症状为腹痛（90%）、呕吐和恶心（80%）。胃壁被产气微生物感染常见为八叠球菌。腹部CT扫描在95%的病例中发现了气肿性改变。内镜检查显示80%的患者有胃黏膜红斑，80%的病例白细胞增多。大多数恢复率为70%，死亡率为15%；（75%接受药物治疗，25%接受手术治疗），79%接受包括抗生素和支持治疗在内的药物治疗，而在严重病例中21%接受手术治疗。
气肿性胃炎需要多学科方法以获得最佳结果。CT成像对于诊断仍然至关重要，管理应根据疾病严重程度和患者因素个体化。虽然死亡率仍然很高，但早期识别和医疗进展在许多情况下提高了生存率。
