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Gastric emphysema after percutaneous endoscopic gastrostomy placement
  1. Sayaka Mabuchi1,
  2. Hiroya Mabuchi1 and
  3. Takashi Watari2,3
  1. 1General Medicine, Iinan Hospital, Iinan, Shimane, Japan
  2. 2General Medicine Center, Shimane University Faculty of Medicine Graduate School of Medicine, Izumo, Shimane, Japan
  3. 3Master of Healthcare Quality and Safety, University of Michigan Medical Center, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Takashi Watari; wataritari{at}


Emphysematous gastritis and gastric emphysema are different diseases. Sometimes, we treat the diseases without distinguishing them clearly because both are rare, and the mortality rate of emphysematous gastritis cases is high (55%). Gastric emphysema is more well known than is emphysematous gastritis after percutaneous endoscopic gastrostomy (PEG) placement (80%). Particularly, it is a self-healing disease, and treatment with antibiotics is not required. CT is commonly used to diagnose emphysematous gastritis and gastric emphysema. The amount of radiation exposure is a concern for performing multiple CTs following air disappearance in the gastric wall. Here, we report the case of a 92-year-old man with gastric emphysema after PEG. It was useful to follow-up the patient by performing radiographic examination, and the disease was managed conservatively without antibiotic administration. We report that distinguishing gastric emphysema from emphysematous gastritis was necessary. Moreover, performance excessive tests and treatments should be avoided.

  • Air leaks
  • Gas/Free Gas
  • Endoscopy
  • Stomach and duodenum

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  • Contributors SM and HM cared for the patient and wrote the manuscript. TW revised the manuscript and supervised every process.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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