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Case report
Emphysematous gastritis associated with gastric cancer: a rare and fatal entity
  1. Margarida Rodrigues Fonseca1,
  2. Mariana Constante1,
  3. Anne Moura2 and
  4. Ivone Melo Valadão1
  1. 1Medicine I, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  2. 2Intensive Care Unit, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
  1. Correspondence to Margarida Rodrigues Fonseca; margarida.rfonseca{at}


Emphysematous gastritis is a rare disease characterised by air in the wall of the stomach due to gas-forming microorganisms. This is a highly lethal entity for which only prompt diagnosis and treatment can avoid mortality. Different factors have been described that disrupt the integrity of the mucosa such as corrosive ingestion, alcohol abuse, recent abdominal surgery or cancer. We report a case of emphysematous gastritis in a 92-year-old woman who presented to the emergency department with abdominal pain, nausea and vomiting. Inflammatory markers were elevated and abdominal X-rays showed intramural gastric air, confirmed by CT scan. The patient received intravenous fluids, nutritional support and broad-spectrum antibiotic with resolution of gastric wall emphysema. However, the diagnosis of poorly cohesive gastric adenocarcinoma was made and the patient was referred to palliative care. This case highlights the importance of prompt recognition of this lethal entity that represents a rare and aggressive presentation of gastric cancer.

  • gas/free gas
  • stomach and duodenum

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  • Contributors MRF contributed to the planning, conduct and reporting of the work described in the article. AM, MC and IMV contributed to conduct the work described in the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.