# A Case of Emphysematous Gastritis Managed With Conservative Treatment

## TL;DR

A 67-year-old man with emphysematous gastritis was successfully treated with conservative methods, avoiding surgery.

## Contribution

This case highlights the successful use of non-surgical treatment for a rare and severe gastric condition.

## Key findings

- Emphysematous gastritis was diagnosed using CT imaging showing gastric wall inflammation and intramural gas.
- Conservative treatment with antibiotics, fluids, and decompression led to symptom improvement and stable discharge.
- The patient's encephalopathy and bradycardia resolved during inpatient care.

## Abstract

Emphysematous gastritis is a rare condition associated with a high mortality rate. It is associated with various medications, chronic medical problems, and ingestions. Individuals can present with abdominal symptoms and even hemodynamic changes. Evaluating the patient with computed tomography (CT) imaging can show inflammation of the gastric wall and intramural gas. A conservative approach is often used to treat emphysematous gastritis, although surgical intervention may be necessary. Our case involves a 67-year-old male patient who presented with acute encephalopathy and bradycardia. He was noted to have epigastric tenderness, so non-contrast CT imaging of the abdomen and pelvis was performed. The imaging revealed emphysematous gastritis. Our patient was successfully managed with intravenous antibiotics, intravenous fluids, proton-pump inhibitors, and nasogastric decompression. His encephalopathy and other symptoms improved while inpatient, and he was discharged in stable condition.