World Journal of Surgery

, Volume 39, Issue 4, pp 1008–1017 | Cite as

Emphysematous Gastritis and Gastric Emphysema: Similar Radiographic Findings, Distinct Clinical Entities

  • Kazuhide MatsushimaEmail author
  • Eugene J. Won
  • Matthew R. Tangel
  • Laura M. Enomoto
  • Diego M. Avella
  • David I. Soybel
Scientific Review



Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders.


We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE.


A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1 % of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55 %) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29 %) was attributable to comorbid conditions and the underlying illness.


Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.


Total Gastrectomy Gastric Wall Stomach Wall Gastric Outlet Obstruction Gastric Distension 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest



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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Kazuhide Matsushima
    • 1
    • 2
    Email author
  • Eugene J. Won
    • 2
  • Matthew R. Tangel
    • 2
  • Laura M. Enomoto
    • 2
  • Diego M. Avella
    • 2
  • David I. Soybel
    • 2
  1. 1.Department of SurgeryUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of SurgeryPenn State Milton S. Hershey Medical CenterHersheyUSA

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