Emphysematous gastritis

Emphysematous gastritis is characterized by the pres- ence of intramural gas produced by bacteria in situ in the gastric wall. It is an uncommon and severe form of phlegmonous gastritis, associated with a high mortality. We report two cases of emphysematous gastritis. First case : a 64-year-old alcoholic man presented with acute epigastric pain radiating to the back, distended abdomen and hematemesis. C-reactive protein level was 322 mg/l. Three hours later, the patient experienced sud- den exacerbation of the pain, with abdominal guarding. CT scan showed symmetrical thickening of the gastric wall with presence of intra-parietal air bubbles and peri- toneal effusion (Fig. 1).