Nahar Shamsun, Field Eric, Begum Rokeya, Islam Nipa, Hasan Nahid
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Hospital Medicine, Augusta Health, Fisherville, USA.
Cureus. 2025 Aug 18;17(8):e90360. doi: 10.7759/cureus.90360. eCollection 2025 Aug.
Emphysematous gastritis (EG) is a rare but potentially fatal form of gastric pneumatosis caused by gas-forming organisms infiltrating the gastric wall, often in the context of mucosal injury or systemic vulnerability such as chronic alcohol use. We present the case of a 55-year-old male with a history of daily alcohol consumption who arrived with severe epigastric pain and over 100 episodes of vomiting in a single day. Laboratory findings revealed leukocytosis, electrolyte imbalances, and acute kidney injury, while CT imaging showed gas within the gastric wall, consistent with EG. The patient responded favorably to conservative management, including intravenous antibiotics, proton pump inhibitors, fluid resuscitation, and symptomatic care. Although microbiological confirmation was not obtained, the clinical course strongly suggested an infectious etiology. This case highlights the importance of distinguishing EG from gastric emphysema, initiating early empirical therapy, and addressing underlying risk factors such as alcohol use to improve outcomes.
气肿性胃炎（EG）是一种罕见但可能致命的胃积气形式，由产气微生物侵入胃壁引起，通常发生在黏膜损伤或存在慢性酒精使用等全身易损性的情况下。我们报告一例55岁男性病例，该患者有每日饮酒史，因严重上腹部疼痛和单日超过100次呕吐前来就诊。实验室检查结果显示白细胞增多、电解质失衡和急性肾损伤，而CT成像显示胃壁内有气体，符合气肿性胃炎表现。患者对包括静脉用抗生素、质子泵抑制剂、液体复苏和对症治疗在内的保守治疗反应良好。尽管未获得微生物学确诊，但临床病程强烈提示为感染性病因。该病例突出了区分气肿性胃炎与胃扩张、尽早开始经验性治疗以及处理如酒精使用等潜在危险因素以改善预后的重要性。
