Unrevealing emphysematous gastritis: Insight from a comprehensive systematic review

Abstract

BACKGROUND: Emphysematous Gastritis is a rare condition, characterized by the presence of gas within the gastric wall. It is associated with a high mortality rate, but early diagnosis and treatment can significantly reduce mortality and improve patient outcomes. METHODOLOGY: For this systematic review, we searched PubMed, Scopus, Web of Science, and Embase from inception until October 2024 to find relevant case reports or case series on emphysematous gastritis. RESULTS: A 116 case report and case series revealed that patient ages ranged from 4 months to 96 years (mean age: 55), male (55 %). Most cases were reported in Asia and the USA. The majority of symptoms were 90 % abdominal pain, and 80 % vomiting and nausea. Infection of the gastric wall by gas-forming organisms was commonly Sarcina ventriculi. Abdominal CT scans identified emphysematous changes in 95 % of cases. Endoscopic examinations revealed Gastric Mucosal Erythema in 80 % of patients, with elevated leukocytosis in 80 % of cases. The majority of the recovery rate was 70 %, and the mortality rate was 15 %; (75 % received medical treatment,25 % surgical treatment), and 79 % were given medical treatment including antibiotics and supportive care while in severe cases 21 % were surgical. CONCLUSION: Emphysematous Gastritis requires a multidisciplinary approach for optimal outcomes. CT imaging remains pivotal for diagnosis, and management should be individualized based on disease severity and patient factors. While mortality remains significant, early recognition and advancements in medical care have improved survival in many cases.