Mohamed A. B. Elnaggar, MD1, Omar F. Abbas, 2, Roaa Haddad, 3, Mohamed Mohsen Helal, 4, Hala Abou Shawreb, 5, Alaa Adrabou Abouelmagd, 6, Abdullah Almarfadi, 7, Ahmed G. Amer, 4, Yousif Ahmad. Hanafi, 8, Motasem Ayoub, 9, Mohamed A. Aldemerdash, 10, Ismail Elkhattib, MBBCh11, Mohamed Abd El Aziz, MD12, Mohamed Ghallab, MBChB13, Neil D. Parikh, MD1 1Hartford Healthcare, Hartford, CT; 2Al-Azhar University, Cairo, Al Qahirah, Egypt; 3October 6 university. Faculty of Medicine, October 6, Al Qahirah, Egypt; 4Zagazig University, Faculty of Medicine, Zagazig, Ash Sharqiyah, Egypt; 5Mansoura University, Mansoura, Al Qalyubiyah, Egypt; 6South Valley University, South Valley, Qina, Egypt; 7Ferhat Abbas University of Setif, Setif, Setif, Algeria; 8Al-Azhar University Faculty of medicine, Cairo, Al Qahirah, Egypt; 9The Hashemite University, Zarqa, 'Amman, Jordan; 10Sohag University, Faculty of Medicine, Sohag, Suhaj, Egypt; 11University of Nebraska, Hartford, CT; 12Deaconess health system, Henderson, KY; 13UPMC Western Maryland, Cumberland, MD Introduction: Emphysematous Gastritis is a rare and fatal condition. It is associated with a high mortality rate, but early diagnosis and treatment can significantly reduce mortality and improve patient outcomes. We aim to compile relevant data from known cases of Emphysematous Gastritis to enhance our understanding of the disease Methods: We searched PubMed, Scopus, Web of Science, Embase from inception until October 2024 to find relevant case reports or case series on emphysematous gastritis Results: A 116 case reports and case series revealed that patient ages ranged from 4 months to 96 years (mean age: 55), male (60%). 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) Discussion: This review highlights the clinical and diagnostic characteristics, management strategies, and outcomes of emphysematous gastritis. Emphysematous gastritis (EG), though rare, is a severe condition that requires prompt recognition and management due to its potential for high morbidity and mortality. CT was consistently the dominant diagnostic modality across the included cases. As an initial imaging test, CT is highly sensitive for detecting hallmark features such as gastric wall thickening, intramural gas, and portal venous gas. Management approaches were categorized into medical management, such as broad-spectrum antibiotics, fluid resuscitation, and supportive care, as well as surgical interventions, including partial or total gastrectomy. Mortality rates varied across reported cases but were generally lower than historically described for Emphysematous Gastritis Advances in diagnostic imaging, early initiation of antibiotics, and critical care support may have contributed to improved survival rates in recent reports. Despite this, the condition remains life-threatening, needs close monitoring and timely intervention. 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.
Figure: Figure(1): Gender, Common comorbidities and Age distribution outlines in our Emphysematous Gastritis systematic review article.
Figure: Figure(2): Diagnostic tools and Global case distribution of Emphysematous Gastritis cases
Disclosures: Mohamed A. Elnaggar indicated no relevant financial relationships. Omar F. Abbas indicated no relevant financial relationships. Roaa Haddad indicated no relevant financial relationships. Mohamed Mohsen Helal indicated no relevant financial relationships. Hala Abou Shawreb indicated no relevant financial relationships. Alaa Adrabou Abouelmagd indicated no relevant financial relationships. Abdullah Almarfadi indicated no relevant financial relationships. Ahmed Amer indicated no relevant financial relationships. Yousif Hanafi indicated no relevant financial relationships. Motasem Ayoub indicated no relevant financial relationships. Mohamed A. Aldemerdash indicated no relevant financial relationships. Ismail Elkhattib indicated no relevant financial relationships. Mohamed Abd El Aziz indicated no relevant financial relationships. Mohamed Ghallab indicated no relevant financial relationships. Neil Parikh indicated no relevant financial relationships.
Mohamed A. B. Elnaggar, MD1, Omar F. Abbas, 2, Roaa Haddad, 3, Mohamed Mohsen Helal, 4, Hala Abou Shawreb, 5, Alaa Adrabou Abouelmagd, 6, Abdullah Almarfadi, 7, Ahmed G. Amer, 4, Yousif Ahmad. Hanafi, 8, Motasem Ayoub, 9, Mohamed A. Aldemerdash, 10, Ismail Elkhattib, MBBCh11, Mohamed Abd El Aziz, MD12, Mohamed Ghallab, MBChB13, Neil D. Parikh, MD1. P2052 - Unrevealing Emphysematous Gastritis: Insight from a Comprehensive Systematic Review, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
