Case Report
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2005; 11(11): 1719-1721
Published online Mar 21, 2005. doi: 10.3748/wjg.v11.i11.1719
Endoscopic ultrasonographic appearance of gastric emphysema
Maw-Soan Soon, Hsu-Heng Yen, Anny Soon, Otto S. Lin
Maw-Soan Soon, Hsu-Heng Yen, Anny Soon, Department of Gastroenterology, Changhua Christian Medical Center, Changhua, Taiwan, China
Otto S. Lin, Gastroenterology Section, Virginia Mason Medical Center, Seattle, WA 98101, USA
Author contributions: All authors contributed equally to the work.
Correspondence to: Hsu-Heng Yen, M.D., Changhua Christian Medical Center, 135 Nanhsiao Street Changhua , 500 Taiwan, China. 91646@cch.org.tw
Telephone: +886-4-7238595-5501
Received: October 11, 2004
Revised: October 12, 2004
Accepted: October 18, 2004
Published online: March 21, 2005
Abstract

Emphysematous gastritis (or phlegmonous gastritis) and gastric emphysema (or gastric pneumatosis) are variations of conditions associated with the presence of intramural air in the stomach. The presence of air in the gastric wall is a very rare clinical condition, associated with bacterial infection, increased intragastric pressure from gastric outlet obstruction, gastric mucosal disruption or air dissection from the mediastinum. In adults, this can occur in the setting of instrumentation-related injury, gastric outlet obstruction by gastric, duodenal or pancreatic malignancies or bowel ischemia. Here we describe a case of gastric emphysema related to repeated biliary stenting and partial duodenal obstruction in a patient with inoperable periampullary cancer, and provide the first description of the endoscopic ultrasonographic findings of gastric emphysema in the literature. In our case, endoscopic ultrasound showed a band of bright echogenicity arising from the submucosa layer, representing air in the gastric wall.

Keywords: Endoscopic ultrasound; Gastric emphysema; Gastric pneumatosis