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Case Reports
. 2025 Aug 18;17(8):e90360.
doi: 10.7759/cureus.90360. eCollection 2025 Aug.

Emphysematous Gastritis in a Chronic Alcohol User: A Case of Gastric Pneumatosis With Suspected Infectious Etiology

Shamsun Nahar  1 , Eric Field  2 , Rokeya Begum  3 , Nipa Islam  4 , Nahid Hasan  5
Affiliations
Case Reports

Emphysematous Gastritis in a Chronic Alcohol User: A Case of Gastric Pneumatosis With Suspected Infectious Etiology

Shamsun Nahar et al. Cureus. .

Abstract

Emphysematous gastritis (EG) is a rare but potentially fatal form of gastric pneumatosis caused by gas-forming organisms infiltrating the gastric wall, often in the context of mucosal injury or systemic vulnerability such as chronic alcohol use. We present the case of a 55-year-old male with a history of daily alcohol consumption who arrived with severe epigastric pain and over 100 episodes of vomiting in a single day. Laboratory findings revealed leukocytosis, electrolyte imbalances, and acute kidney injury, while CT imaging showed gas within the gastric wall, consistent with EG. The patient responded favorably to conservative management, including intravenous antibiotics, proton pump inhibitors, fluid resuscitation, and symptomatic care. Although microbiological confirmation was not obtained, the clinical course strongly suggested an infectious etiology. This case highlights the importance of distinguishing EG from gastric emphysema, initiating early empirical therapy, and addressing underlying risk factors such as alcohol use to improve outcomes.

Keywords: alcohol; emphysematous gastritis; empiric treatment; gastric emphysema; infectious etiology.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Computed tomography scan of the abdomen (axial view)
The image shows marked distention of the fluid-filled stomach. Blue arrows indicate tracking along the stomach concerning gastric pneumatosis.
Figure 2
Figure 2. Computed tomography scan (coronal view)
Blue arrows indicate the presence of gas within the stomach wall.
See this image and copyright information in PMC

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