Gastric Emphysema
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- Air in the stomach wall with an appearance
similar to emphysematous gastritis with a much more benign
clinical course
- Caused by disruption in mucosa leading to
air dissecting into wall from:
- Gastric outlet obstruction with increased
intraluminal pressure
- Severe vomiting
- Instrumentation-like endoscopy
- Dissection of air from mediastinum from
ruptured bleb or pneumothorax
- Pneumatosis cystoids - submucosal air
collections
Emphysematous gastritis
- Rare and severe gastritis secondary to
mucosal disruption and gas-forming bacterial invasion
- Characterized by air in the wall of the
stomach
- Causes:
- Ingestion of toxic material such as
corrosives
- Alcohol ingestion
- Trauma
- Gastric infarction
- Ulcer disease
- Submucosa is invaded by gas-forming
organisms which include:
- Hemolytic strep
- Clostridia Welchi
- E. Coli
- Staph aureus
- Clinical:
- Sudden and violent onset of bloody
emesis
- Fever
- Nausea
- Chills
- Leukocytosis
- X-ray:
- Linear small gas bubbles in gastric wall
- Gastric emphysema is more linear,
streak-like
- Gas in portal vein
- Prognosis:
- Best way to differentiate emphysematous
gastritis from gastric emphysema:
- Look at patient
- Patients with gastric emphysema are a
asymptomatic from the bowel gas air
- Patients with emphysematous gastritis
are usually deathly ill
WH/wh 03
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