Important pertinent negatives that need mentioning are:

  1. absence of free peritoneal air

  2. absence of portal venous gas

  3. absence of pneumatosis intestinalis or mediastinal emphysema

  4. no NG tube and no history of gastroscopy

Gastroenterology and/or surgery consult important to monitor clinical progress as it is not possible to differentiate emphysematous gastritis from the more benign gastric emphysema.

Urinary tract calculi and hydronephrosis require further investigation.

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