From acid to air: delayed emphysematous gastritis after corrosive ingestion

Emphysematous gastritis is a rare and fulminant variant of phlegmonous gastritis characterised by the presence of gas within the gastric wall due to invasion by gas-forming micro-organisms. Unlike benign gastric emphysema, emphysematous gastritis is associated with systemic toxicity and carries a high mortality rate of around 60%. Known predisposing factors include ingestion of corrosive substances, alcohol abuse, gastric infarction, recent abdominal surgery, ingestion of non-steroidal anti-inflammatory agents, diabetes mellitus, rheumatic diseases and treatment with steroids and other cytotoxins. Current literature suggests that treatment consists of broad-spectrum antibiotics with gram-negative and anaerobic coverage, with surgical intervention reserved for selected cases. We report a case of a young male who developed emphysematous gastritis following corrosive ingestion and recovered successfully with conservative management.