Gastric emphysema, referring to the presence of gas in the wall of the stomach is a relatively rare imaging finding 1. The stomach is the least common location for intramural gas in the gastrointestinal tract.
There is a wide range of causes, ranging from life-threatening emphysematous gastritis to many self-limiting causes. Gastric emphysema is more common than emphysematous gastritis, but the two conditions may appear similarly. Clinical presentation helps distinguish the two.
Gastric emphysema can be broadly divided into two categories based on etiology 2: gastric causes and extragastric causes.
- gastric causes
- emphysematous gastritis (infectious)
- caustic ingestion
- increased intraluminal pressure (such as during endoscopy, severe vomiting or in the setting of bowel obstruction)
- perforated gastric ulcer
- traumatic causes (endoscopic biopsy, endoscopic argon plasma coagulation, tube placement, blunt trauma)
- extragastric causes
- small or large bowel ischaemia
- gangrenous cholecystitis
- dissection of pulmonary gas (such as from rupture of a pulmonary bulla)
- 1. Johnson PT, Horton KM, Edil BH et-al. Gastric pneumatosis: the role of CT in diagnosis and patient management. Emerg Radiol. 2011;18 (1): 65-73. Emerg Radiol (full text) - doi:10.1007/s10140-010-0888-5 - Pubmed citation
- 2. Ba-Ssalamah A, Prokop M, Uffmann M et-al. Dedicated multidetector CT of the stomach: spectrum of diseases. Radiographics. 2003;23 (3): 625-44. doi:10.1148/rg.233025127 - Pubmed citation