BACKGROUND: Gastric pneumatosis is a very rare entity, and of the hollow viscera, the stomach is the least often reported site for intramural gas. OBJECTIVE: To describe a patient with gas in the gastric wall associated with pneumoperitoneum and diffuse ischemic changes of the small and large bowels. PATIENT: Old man with past history of hemodialysis for renal failure and a diffuse vascular atherosclerosis presenting with an acute abdomen. The CT scan of the abdomen revealed a gastric pneumatosis with pneumoperitoneum and complete thrombosis of the coeliac trunk. Laparotomy showed gastric infarction with peritonitis and diffuse changes through the gastrointestinal tract. A therapeutical abstention was decided in agreement with the family. RESULTS: The patient developed septic choc under broad spectrum antibiotic coverage and died after 12 hours of multiple organs failure. CONCLUSION: Surgeons, internists and gastroenterologists should be aware of the possibility of gastric pneumatosis in some cases. Underlying disease are important to clarify in order to apply the adequate treatment.
BACKGROUND:Gastric pneumatosis is a very rare entity, and of the hollow viscera, the stomach is the least often reported site for intramural gas. OBJECTIVE: To describe a patient with gas in the gastric wall associated with pneumoperitoneum and diffuse ischemic changes of the small and large bowels. PATIENT: Old man with past history of hemodialysis for renal failure and a diffuse vascular atherosclerosis presenting with an acute abdomen. The CT scan of the abdomen revealed a gastric pneumatosis with pneumoperitoneum and complete thrombosis of the coeliac trunk. Laparotomy showed gastric infarction with peritonitis and diffuse changes through the gastrointestinal tract. A therapeutical abstention was decided in agreement with the family. RESULTS: The patient developed septic choc under broad spectrum antibiotic coverage and died after 12 hours of multiple organs failure. CONCLUSION: Surgeons, internists and gastroenterologists should be aware of the possibility of gastric pneumatosis in some cases. Underlying disease are important to clarify in order to apply the adequate treatment.
Authors: Kazuhide Matsushima; Eugene J Won; Matthew R Tangel; Laura M Enomoto; Diego M Avella; David I Soybel Journal: World J Surg Date: 2015-04 Impact factor: 3.352