A Case Report Evaluating Gastric Emphysema versus Emphysematous Gastritis.

Journal of education & teaching in emergency medicine Pub Date : 2024-04-30 eCollection Date: 2024-04-01 DOI:10.21980/J8ZH26
Anna Nguyen, Mark Slader, Lindsey Spiegelman
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Abstract

Gastric emphysema (GE) and emphysematous gastritis (EG) share similar clinical presentations but exhibit drastically different prognoses. While GE is generally benign, EG is associated with mortality rates up to 60%. Here, we present the case of a 29-year-old female patient who presented to the emergency department (ED) with symptoms of nausea, vomiting, and epigastric abdominal pain. Clinical evaluation revealed tachycardia, pain out of proportion, leukocytosis, and metabolic acidosis. Computed tomography (CT) scan unveiled the presence of air within the gastric wall, and a presumptive diagnosis of gastric emphysema was made. The patient responded positively to conservative management and was discharged after a two-day hospitalization. This case report emphasizes the need for physicians to adeptly distinguish between GE and EG. Timely identification and precise differentiation of the two conditions allow for timely and tailored management, ultimately leading to improved clinical outcomes in patients. By providing insights into the etiologies, clinical presentations, and imaging findings for the two pathologies, we aim to empower clinicians to make informed decisions for optimal patient care.

Topics: Gastric emphysema, emphysematous gastritis, gastric pneumatosis.

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评估胃气肿与气肿性胃炎的病例报告
胃气肿(GE)和气肿性胃炎(EG)的临床表现相似,但预后却大相径庭。气肿性胃炎一般为良性,而气肿性胃炎的死亡率高达 60%。在此,我们介绍一例因恶心、呕吐和上腹部疼痛症状而到急诊科(ED)就诊的 29 岁女性患者。临床评估显示,患者心动过速、疼痛不成比例、白细胞增多和代谢性酸中毒。计算机断层扫描(CT)显示胃壁内有空气,推测诊断为胃气肿。患者对保守治疗反应良好,住院两天后出院。本病例报告强调了医生熟练区分胃气肿和胃食管气肿的必要性。及时发现并准确区分这两种病症有助于及时采取有针对性的治疗,最终改善患者的临床预后。通过深入了解这两种病症的病因、临床表现和影像学检查结果,我们旨在使临床医生能够做出明智的决定,为患者提供最佳治疗:胃气肿、气肿性胃炎、胃积气。
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