A case of emphysematous gastritis with portal venous gas

A 52-year-old woman was diagnosed with esophageal perforation, sepsis and infective endocarditis (IE) , and she was hospitalized for more than half a year. As oral ingestion proved difficult, intestinal nutrition via naso-gastric tube was initiated. Two days later, she developed hematemesis. Esophagogastroendoscopy revealed mucosal congestion, edema and multiple erosive lesions in the posterior gastric wall. Gas in the gastric wall and wall thickening, accompanied by hepatic portal venous gas, were demonstrated by enhanced CT scan. Based on these findings, the patient was diagnosed with emphysematous gastritis with hepatic portal venous gas. E.coli, gas-producing bacteria, developed in the patient’s gastric juice. It was thought that mucosal damage was caused by the tube. Her clinical symptoms improved with the administration of antibiotics. Gastric tube placement is one of the risks of emphysematous gastritis, and early diagnosis and treatment appear to be crucial when this disease is suspected.