Korean J Gastroenterol.  2011 Jul;58(1):38-41. 10.4166/kjg.2011.58.1.38.

A Case of Emphysematous Gastritis in a Patient with End-stage Renal Disease

  • 1Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea. jhcho9328@kd.ac.kr


Emphysematous gastritis is a rare infection of the stomach wall with high mortality rate. It is caused by gas forming organisms and may arise by local spread through the mucosa or hematogenous dissemination from distant focus. Clinical manifestation includes acute abdomen with systemic toxicity, and diagnosis is based on radiologic demonstration of gas within the gastric wall. Treatment should be aimed to cover gram-negative organisms and anaerobes using wide-spectrum intravenous antibiotics, and sometimes surgical management may be needed in order to enhance survival. Herein, we report a case of emphysematous gastritis in a patient with end stage renal disease on hemodialysis.


Emphysematous gastritis; End-stage renal disease; Hemodialysis

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Kidney Failure, Chronic/complications/*diagnosis
Klebsiella pneumoniae/isolation & purification
Middle Aged
Renal Dialysis
Tomography, X-Ray Computed


  • Fig. 1. Abdominal x-ray and CT scan findings. (A) Gas was noted in the wall of the dilated stomach. (B, C) The wall of the stomach had irregular mottled gas (arrow).

  • Fig. 2. Endoscopic findings. (A) The gastric mucosa of antrum had inflammation and covered with gastritis and dirty discharges. (B, C) No evidence of ulcer and necrosis at the fundus and body of the stomach was noted.

  • Fig. 3. Abdominal x-ray and CT scan findings (follow up). (A) The stomach gas was decreased. (B, C) The gastric wall became not remarkable.



1. Yalamanchili M, Cady W. Emphysematous gastritis in a hemodialysis patient. South Med J. 2003; 96:84–88.
2. Allan K, Barriga J, Afshani M, Davila R, Tombazzi C. Emphysematous gastritis. Am J Med Sci. 2005; 329:205–207.
3. Huang CT, Liao WY. Emphysematous gastritis: a deadly infectious disease. Scand J Infect Dis. 2009; 41:317–319.
4. Ocepek A, Skok P, Virag M, Kamenik B, Horvat M. Emphysematous gastritis – case report and review of the literature. Z Gastroenterol. 2004; 42:735–738.
5. Carlson AP, Chan JW, Ketai LH, Demarest GB. Emphysematous gastritis in a severely burned patient: case report and literature review. J Trauma. 2007; 62:765–767.
6. Al-Jundi W, Shebl A. Emphysematous gastritis: case report and literature review. Int J Surg. 2008; 6:e63–e66.
7. van Mook WN, van der Geest S, Goessens ML, Schoon EJ, Ramsay G. Gas within the wall of the stomach due to emphysematous gastritis: case report and review. Eur J Gastroenterol Hepatol. 2002; 14:1155–1160.
8. Lee SM, Kim GH, Kang DH, Kim TO, Song GA, Kim S. Education and imaging. Gastrointestinal: emphysematous gastritis. J Gastroenterol Hepatol. 2007; 22:2036.
9. Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001; 45:64–66.
10. Van Allan RJ, Krebs TL, Henzie GM, Fermelia DE, Fichman MP. Emphysematous gastritis in an immunocompromised host. Clin Imaging. 1995; 19:129–130.
11. Cherney CL, Chutuape A, Fikrig MK. Fatal invasive gastric mu-cormycosis occurring with emphysematous gastritis: case report and literature review. Am J Gastroenterol. 1999; 94:252–256.
12. Loi TH, See JY, Diddapur RK, Issac JR. Emphysematous gastritis: a case report and a review of literature. Ann Acad Med Singapore. 2007; 36:72–73.
13. Jung JH, Choi HJ, Yoo J, Kang SJ, Lee KY. Emphysematous gastritis associated with invasive gastric mucormycosis: a case report. J Korean Med Sci. 2007; 22:923–927.
14. Lin CY, Lee CS, Lin DY, et al. Emphysematous gastritis secondary to acute gastric dilatation. J Gastroenterol Hepatol. 1995; 10:612–615.
15. Cheong JY, Lee DH, Park WI, et al. Emphysematous gastritis developed in a patient with Klatskin's tumor. Korean J Gastrointest Endosc. 2004; 28:34–38.
16. Lee CH, Bak YT, Choi KM, et al. Two cases of acute phlegmonous gastritis. Korean J Gastrointest Endosc. 1995; 15:79–83.
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