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. 2021 Dec:89:106584.
doi: 10.1016/j.ijscr.2021.106584. Epub 2021 Nov 11.

Gastric pneumatosis and concurrent aeroportia due to gastric outlet obstruction: A case report

Manoochehr Ebrahimian  1 , Negin Ghayebi  2 , Seyed Parviz Rezaee  3
Affiliations

Gastric pneumatosis and concurrent aeroportia due to gastric outlet obstruction: A case report

Manoochehr Ebrahimian et al. Int J Surg Case Rep. 2021 Dec.

Abstract

Introduction and importance: Gastric pneumatosis with concurrent hepatic portal vein gas is an extremely rare condition in the adult population. It can be idiopathic or associated with well-known etiologies. Gastric outlet obstruction can progressively inflate the stomach and cause pneumatosis. Regarding abdominal signs and the presence of acute abdomen, management varies from just conservative to emergent surgical interventions.

Case presentation: We introduce an adult patient who presented to our hospital with weakness and dyspnea. After initial measures, unexpectedly we found intraabdominal free gas, concurrent gastric pneumatosis, and aeroportia. Due to the absence of positive abdominal signs, the patient was treated successfully without any surgical or endoscopic interventions.

Discussion: Gastric outlet obstruction is a well-known cause of gastric pneumatosis. Progressive dilation of the stomach due to pyloric stenosis is well-described both in infants and adult populations.

Conclusion: In stable patients, gastric drainage and correction of electrolyte disturbance are the only required treatment. However endoscopic and surgical interventions should be considered in unstable patients or those developing acute abdomen.

Keywords: Aeroportia; Gastric emphysema; Gastric outlet obstruction; Gastric pneumatosis; Pneumoperitoneum.

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Conflict of interest statement

The authors declared no potential conflict of interests with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Normal chest x-ray.
Fig. 2
Fig. 2
CT, axial views. Red arrows indicate gas inside the stomach wall or biliary tract. These three progressive views show the extent of stomach volume and pneumatosis. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
CT, coronal view shows a huge stomach with pneumatosis inside its wall.
See this image and copyright information in PMC

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