title: Emphysematous gastritis and gastric emphysema: similar radiographic findings, distinct clinical entities.
abstract: BACKGROUND
  Despite similar appearances on imaging studies, emphysematous gastritis (EG) and gastric emphysema (GE) are rare clinical entities encountered in surgical practices. The purpose of this review is to clarify the presentation, natural history, and optimal treatment strategies for these two disorders.
  
  
  METHODS
  We conducted a comprehensive literature review for reported adult cases of EG and GE in MEDLINE. Two cases from our institution were also included. Patient with demographics, diagnostic and therapeutic data, and outcomes were compared between patients with EG and GE.
  
  
  RESULTS
  A total of 75 cases were included for our review. The finding of intramural air in the stomach was often associated with portal vein gas, pneumatosis intestinalis, or pneumoperitoneum in both groups. Surgical removal of the stomach was performed in 23.1% of EG patients, but only one patient in the GE group. In the EG group, overall mortality (55%) appeared to be driven by sepsis and its complications, whereas in the GE group, mortality (29%) was attributable to comorbid conditions and the underlying illness.
  
  
  CONCLUSIONS
  Prompt surgical intervention is more commonly indicated for severe EG and is directed at removal of the septic organ, while the primary indication for surgical intervention in GE is the uncertainty of the diagnosis.
authors.affiliation: Department of Surgery, University of Southern California, 1200 N. State Street, Inpatient Tower (C), Rm C5L100, Los Angeles, CA, 90033, USA, mkazu45@gmail.com.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Matsushima
authors.forename: Eugene J
authors.initials: EJ
authors.lastname: Won
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Tangel
authors.forename: Laura M
authors.initials: LM
authors.lastname: Enomoto
authors.forename: Diego M
authors.initials: DM
authors.lastname: Avella
authors.forename: David I
authors.initials: DI
authors.lastname: Soybel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications*; D003937:Diagnosis, Differential; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000628:therapy; D016145:Endoscopy, Digestive System; D005743:Gastrectomy; D005756:Gastritis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D011169:Portal Vein / Q000000981:diagnostic imaging; D011859:Radiography; D018805:Sepsis / Q000382:microbiology; D013272:Stomach Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents