P5096 - A Review of Literature of Gastric Emphysema vs Emphysematous Gastritis: Highlighting the Importance of Differential Diagnosis

Sahil Sabharwal, MD, Wade Arthur, DO, Dylan Travis, BS, Christopher Clark, MD, Robert Donnell, MD, Kristen Brandon, MD
University of Arkansas for Medical Sciences, Fayetteville, AR

Introduction: Gastric emphysema, also referred to as gastric pneumatosis, and emphysematous gastritis represent two distinct pathologies characterized by notably different prognoses and clinical trajectories. Nevertheless, the diagnostic challenge arises from their strikingly similar initial clinical presentations, in addition to their conspicuously similar nomenclature.

Case Description/Methods: This case report centers around an 86-year-old female presenting with intractable emesis. Initially, radiological interpretations indicated emphysematous gastritis, an exceedingly rare pathology associated with a reported mortality exceeding 50%. Consequently, aggressive clinical management was promptly initiated with both medical and surgical interventions considered. However, subsequent clinical evaluation and observed patient improvement prompted a departure from the initial diagnosis of emphysematous gastritis towards the more benign diagnosis of gastric emphysema.

Discussion: Despite this diagnostic shift, the urgency of immediate clinical intervention and timely treatment for emphysematous gastritis remained paramount, given its elevated mortality rates, even in the absence of definitive diagnostic criteria. Thus, navigating the diagnostic ambiguities was pivotal for this patient, considering the starkly different clinical outcomes, particularly mortality rates, associated with these two conditions despite their similar initial presentations. This underscores both the lack of and need for comprehensive documentation of both conditions to advance clinical understanding and awareness, facilitating improved differentiation, and management of these gastrointestinal pathologies.



Disclosures:


Sahil Sabharwal, MD, Wade Arthur, DO, Dylan Travis, BS, Christopher Clark, MD, Robert Donnell, MD, Kristen Brandon, MD. P5096 - A Review of Literature of Gastric Emphysema vs Emphysematous Gastritis: Highlighting the Importance of Differential Diagnosis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.