Author/Authors :
Petrovic , Igor Department of Surgery - University Hospital Centre Zagreb, Croatia , Sremac, Maja Department of Gastroenterology - University Hospital Centre Zagreb , Croatia , Grbavac, Dario Department of Surgery - University Hospital Centre Zagreb, Croatia , Pavlek, Goran Department of Surgery - University Hospital Centre Zagreb, Croatia , Bogut, Ante Department of Surgery - University Hospital Sveti Duh,Croatia , Bakula, Branko Department of Surgery - University Hospital Sveti Duh,Croatia , Romic, Renata Health Centre Zagreb - Family Medicine, Croatia , Romic, Ivan Department of Surgery - University Hospital Centre Zagreb, Croatia
Abstract :
Intramural gas in the stomach associated with hepatic portal venous gas is a rare entity,
which suggests ischemic or infectious pathology of the stomach. We report a case of a 73-year-
old man who presented with epigastric pain and nausea of 6 hours duration followed by he-
matemesis. The patient had pale skin, anemia, and a diffusively tender and distended abdomen.
Abdominal radiography and computed tomography (CT) revealed gas in thickened gastric wall
and gas in intrahepatic portal vein branches. Surgery was indicated, which consisted of partial
gastrectomy with Roux en esophago-jejunal anastomosis. Postoperative course was uneventful,
and pathohistological analysis indicated stomach wall necrosis with emphysametous gastritis
(EG). The patient was free of symptoms at 2 years follow-up. Intramural gas in the stomach
should always be meticulously investigated to differentiate between emphysematous gastritis
and gastric emphysema, as this would direct the therapeutic approach to be adopted.
