Learning objectives
To review clinical and pathological features of GE
To present the role of radiologist in detection and monitoring GE
Background
The presence of gas within the gastrointestinal tract is a rare condition which was first described in 1889 by Fraenkel. It can appear from esophagus to the rectum and stomach is the least frequent location (9% of all cases). (1)
Emphysematous gastritis (EG) and gastric emphysema (GE) are two different diseases that are categorized under gastric pneumatosis (GP) and the clinical significance varies considerably depending on the cause.
The infectious form of GP, EG, is an infectious process resulting from presence of gas-forming organisms, such...
Findings and procedure details
GP is an uncommon radiological finding which can represent either GE or EG. These two conditions differ a lot in management and prognosis, so diagnosis should be made with a thorough history, physical examination, and clinical presentation. (6) EG and GE look remarkably similar on imaging.
The main tools leading to diagnosis and monitoring remain the plain abdominal radiography and abdominal computed tomography (CT) scan. According to some authors, an ultrasound scan can be used because it reveals whether there is an intramural gastric gas....
Conclusion
Intramural gastric air is an uncommon but important radiological sign to recognize as it may represent either of two conditions: EG or GE.
EG and GE remain two important differential diagnoses of intramural gastric air. They differ in their clinical presentation, radiographic findings, management and prognosis. Successful treatment depends on early diagnosis, control of risk factors, early antifungal therapy and surgical debridement of necrotic tissue if necessary.
The establishment of the presence of intramural gastric air is important from management and prognostic standpoints and the...
Personal information and conflict of interest
A. E. Szubert-Franczak; Warsaw/PL - nothing to disclose J. Pałucki; 781/PL - nothing to disclose A. Cieszanowski; Warsaw/PL - nothing to disclose
References
López-Medina G, Castillo Díaz de León R, Heredia-Salazar A, Hernández-Salcedo D. Gastric Emphysema a Spectrum of Pneumatosis Intestinalis: A Case Report and Literature Review.
Fleisig N, Hayes M. Bacterial invasion resulting from gastrointestinal operations.
https://deepblue.lib.umich.edu/bitstream/handle/2027.42/72543/j.1440-1673.1984.tb02363.x.pdf?sequence=1
Emphysematous gastritis: a case report: https://www.researchgate.net/publication/311973280_Emphysematous_gastritis_a_case_report
T. Zander, V. Briner, F. Buck, and R. Winterhalder, “Gastric pneumatosis following polychemotherapy,” European Journal of Internal Medicine, vol. 18, no. 3, pp. 251–252, 2007.
Ghneim A, Meegada S. Gastric Emphysema Induced by Severe Vomiting. Cureus. 2019;
Zenooz NA, Robbin MR, Perez V. Gastric...