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Gastric emphysema secondary to severe vomiting: a comparative review of 14 cases
  1. Faisal Inayat1,
  2. Fahad Zafar2,
  3. Muhammad Adnan Zaman1,
  4. Qulsoom Hussain3
  1. 1Allama Iqbal Medical College, Lahore, Pakistan
  2. 2King Edward Medical University, Lahore, Pakistan
  3. 3Shifa College of Medicine, Islamabad, Pakistan
  1. Correspondence to Dr Faisal Inayat, faisalinayat{at}


Gastric emphysema is characterised by the presence of air within the wall of the stomach. The radiographic finding of gastric emphysema with hepatic portal venous gas is classically an ominous sign, associated with a high mortality rate. We report one case from our clinical experience and undertake a review of the previously reported cases of vomiting-induced gastric emphysema retrieved from the PubMed. A total of 14 cases were found to date. The mean age at the time of diagnosis was 45.6 years (range, 9 months to 81 years). Computed tomography abdomen was the frequently used diagnostic modality. Interestingly, conservative treatment led to a clinical cure and resolution of gastric emphysema as well as the associated hepatic portal venous gas in most of the patients. This review illustrates that vomiting-related gastric emphysema entails a more benign course and surgical intervention can be avoided with a prompt aetiology establishment in these patients.

  • stomach and duodenum
  • stomach wall
  • portal vein
  • gastrointestinal surgery
  • healthcare improvement and patient safety

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  • Contributors FI: designed the study, performed the literature review, drafted the manuscript, formulated the data table, revised the manuscript critically for important intellectual content and gave the final approval for the version published. FZ: performed the literature review, formulated the data table and contributed to the discussion. MAZ: contributed to the case presentation. QH: reviewed the manuscript and suggested pertinent modifications.

  • 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 Obtained.

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

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