Emphysematous Gastritis Precipitated by Malignant Gastric Outlet Obstruction from Advanced Pancreatic Ductal Adenocarcinoma.

Authors

Yong Yang Lim

Published in

European journal of case reports in internal medicine. Volume 13. Issue 10. Pages 007418. Epub Sep 14, 2026.

Abstract

Emphysematous gastritis is a rare, frequently fatal infection of the gastric wall caused by gas-forming organisms. Gastric outlet obstruction is well recognised as a cause of benign gastric emphysema but is seldom reported as a precipitant of emphysematous gastritis. This report adds a rare presentation of emphysematous gastritis with malignant gastric outlet obstruction as a risk factor.
An 86-year-old man with locally advanced pancreatic ductal adenocarcinoma presented after a fall preceded by generalised weakness, abdominal bloating, diarrhoea, nausea and fever. He was hypotensive and tachycardic, with acute kidney injury and severe high anion gap metabolic acidosis. Computed tomography scan demonstrated a markedly distended stomach with intramural gas and distal obstruction from progressive pancreatic malignancy; blood cultures were negative. He was managed non-operatively with aggressive resuscitation, broad-spectrum intravenous antibiotics and gastric decompression, with subsequent clinical, biochemical and radiological improvement.
Malignant gastric outlet obstruction, compounded by chemotherapy-related immunosuppression, can precipitate emphysematous gastritis. In selected patients without perforation or ischaemia, even those who are frail and immunocompromised, conservative management can achieve resolution.
Malignant gastric outlet obstruction from advanced pancreatic cancer can precipitate emphysematous gastritis, a rare and often fatal infection, particularly when compounded by chemotherapy-related immunosuppression.This case adds to the growing evidence that carefully selected patients without perforation or ischaemia can be managed conservatively with antibiotics and gastric decompression rather than surgery.

PMID:
42877802
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.