La importancia de reconocer la gastritis enfisematosa a tiempo

An 82-year-old man presented with bloating and generalized abdominal pain, accompanied by vomiting (dark in color, with an aspect of retention vomiting) and diarrheic stools. A plain abdominal x-ray (Fig. 1) showed air in the gastric wall and bowel segment dilation. An abdominal computed tomography (CT) scan was ordered (Fig. 2) that revealed intramural gas associated with gastric dilation, pneumoperitoneum (Fig. 3), and gas in the portal vein (Fig. 4). An exploratory laparotomy was performed, finding a distended stomach with gas bubbles in its serosa and no signs of transmural necrosis or perforation. Intraoperative gastroscopy identified ulcerated-necrotic mucosa with no spontaneous bleeding on the posterior surface, body, and greater curvature. Given those findings, no further surgical act was carried out. Lactobacillus jensenii was isolated in blood cultures and treated with meropenem + linezolid. The patient progressed favorably, with improvement in the control abdominal CT scan, and was released from the hospital. Emphysematous gastritis is a rare pathology produced