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Emphysematous gastritis with hepatic portal venous gas: a shift towards conservative management

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A female aged 94 years with a history of diabetes presented with acute onset abdominal pain, haematemesis and altered mental status. She denied alcoholism, corrosive ingestion, pancreatitis or abdominal trauma.… Click to show full abstract

A female aged 94 years with a history of diabetes presented with acute onset abdominal pain, haematemesis and altered mental status. She denied alcoholism, corrosive ingestion, pancreatitis or abdominal trauma. She appeared toxic and was hypotensive. Her hemogram showed leucocytosis at 14.8 x 10^9/L. CT scan of the abdomen showed air scattered within the liver, portal vein and gastric wall (figures 1 and 2). Also, dense calcifications of the aorta and abdominal arteries were noted (figure 3). Due to the high risk of surgery, she was managed conservatively with proton pump …

Keywords: hepatic portal; emphysematous gastritis; portal venous; gastritis hepatic; venous gas; gas shift

Journal Title: BMJ Case Reports
Year Published: 2017

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