Emphysematous gastritis and gastric emphysema: Similar radiographic findings, distinct clinical entities

Kazuhide Matsushima, Eugene J. Won, Matthew R. Tangel, Laura M. Enomoto, Diego M. Avella, David Soybel

Research output: Contribution to journalReview article

19 Citations (Scopus)

Abstract

Introduction: Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders. Methods: We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE. Results: A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1 % of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55 %) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29 %) was attributable to comorbid conditions and the underlying illness. Conclusions: Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.

Original languageEnglish (US)
Pages (from-to)1008-1017
Number of pages10
JournalWorld Journal of Surgery
Volume39
Issue number4
DOIs
StatePublished - Jan 1 2015

Fingerprint

Emphysema
Gastritis
Stomach
Pneumoperitoneum
Mortality
Portal Vein
Natural History
MEDLINE
Uncertainty
Sepsis
Gases
Air
Demography
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Matsushima, Kazuhide ; Won, Eugene J. ; Tangel, Matthew R. ; Enomoto, Laura M. ; Avella, Diego M. ; Soybel, David. / Emphysematous gastritis and gastric emphysema : Similar radiographic findings, distinct clinical entities. In: World Journal of Surgery. 2015 ; Vol. 39, No. 4. pp. 1008-1017.
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abstract = "Introduction: Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders. Methods: We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE. Results: A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1 {\%} of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55 {\%}) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29 {\%}) was attributable to comorbid conditions and the underlying illness. Conclusions: Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.",
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Emphysematous gastritis and gastric emphysema : Similar radiographic findings, distinct clinical entities. / Matsushima, Kazuhide; Won, Eugene J.; Tangel, Matthew R.; Enomoto, Laura M.; Avella, Diego M.; Soybel, David.

In: World Journal of Surgery, Vol. 39, No. 4, 01.01.2015, p. 1008-1017.

Research output: Contribution to journalReview article

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T1 - Emphysematous gastritis and gastric emphysema

T2 - Similar radiographic findings, distinct clinical entities

AU - Matsushima, Kazuhide

AU - Won, Eugene J.

AU - Tangel, Matthew R.

AU - Enomoto, Laura M.

AU - Avella, Diego M.

AU - Soybel, David

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Introduction: Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders. Methods: We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE. Results: A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1 % of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55 %) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29 %) was attributable to comorbid conditions and the underlying illness. Conclusions: Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.

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