Alshahwan N, Alqarzaie AA, Aldeligan SH, Alqusiyer AA, Alnumay A, Mashbari H, Alkanhal A. Successful conservative management of emphysematous gastritis in an elderly patient with multiple comorbidities: A case report. World J Gastrointest Surg 2025; 17(7): 107046 [DOI: 10.4240/wjgs.v17.i7.107046]
Corresponding Author of This Article
Saleh Husam Aldeligan, College of Medicine, King Saud University, P.O Box 2925, Riyadh 11416, Saudi Arabia. saleh.aldeligan@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2025; 17(7): 107046 Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.107046
Successful conservative management of emphysematous gastritis in an elderly patient with multiple comorbidities: A case report
Nawaf Alshahwan, Abdullah A Alqarzaie, Saleh Husam Aldeligan, Abdulaziz Abdulmuhsin Alqusiyer, Abdulaziz Alnumay, Hassan Mashbari, Abdulaziz Alkanhal
Nawaf Alshahwan, Abdulaziz Alkanhal, Trauma and Acute Care Surgery Unit, Department of Surgery, King Saud University, Riyadh 11416, Saudi Arabia
Abdullah A Alqarzaie, Department of Surgery, King Saud University, Riyadh 11416, Saudi Arabia
Saleh Husam Aldeligan, Abdulaziz Abdulmuhsin Alqusiyer, College of Medicine, King Saud University, Riyadh 11416, Saudi Arabia
Abdulaziz Alnumay, Bariatric Centre, King Saud University, Riyadh 11416, Saudi Arabia
Hassan Mashbari, Department of Surgery, Jazan University, Jazan 6809, Saudi Arabia
Author contributions: Alshahwan N revised the final manuscript and supervised the study; Alqarzaie AA drafted the manuscript; Aldeligan SH and Alqusiyer AA collected the case information; Alnumay A, Mashbari H, and Alkanhal A contributed to the study methodology and manuscript writing; All authors read and approved the final manuscript.
Informed consent statement: An informed written consent was signed by the patient for publication of this case.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Saleh Husam Aldeligan, College of Medicine, King Saud University, P.O Box 2925, Riyadh 11416, Saudi Arabia. saleh.aldeligan@gmail.com
Received: March 14, 2025 Revised: April 24, 2025 Accepted: May 28, 2025 Published online: July 27, 2025 Processing time: 131 Days and 23.7 Hours
Abstract
BACKGROUND
Emphysematous gastritis (EG) is a rare and serious condition that has fatal consequences. Although its clinical presentation is not specific, radiological imaging is characterized by intramural gastric gas. Defects in the stomach mucosal barrier and invasion of gas-producing organisms are believed to be the cause.
CASE SUMMARY
An 88-year-old male with multiple comorbidities presented to our center with abdominal pain and increased stoma output as chief complaints. Upon further investigation he was found to have EG. Despite the high mortality risk without intervention, the patient and family declined operative intervention.
CONCLUSION
This case report underscored the challenges of managing a critically ill elderly patient with a history of multiple comorbidities and extensive abdominal surgeries and highlighted the successful use of conservative measures in treating EG.
Core Tip: Emphysematous gastritis is a rare gastrointestinal emergency that can be life-threatening. It occurs when gas accumulates in the stomach wall due to gas-producing bacteria or ischemia. The patient reported in this case received successful non-surgical management despite having multiple health comorbidities and a history of several abdominal surgeries, reflecting the high mortality risk associated with emphysematous gastritis. This medical presentation underscored the importance of early diagnosis and demonstrated how non-operative therapy can be advantageous for elderly patients who are high risk.
