{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:49:39Z","timestamp":1791370179887,"version":"4.3.1"},"reference-count":10,"publisher":"SMC Media","issue":"10","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: 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. Case description: 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. Conclusion: 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.<\/jats:p>","DOI":"10.12890\/2026_007418","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:01:54Z","timestamp":1790121714000},"source":"Crossref","is-referenced-by-count":0,"title":["Emphysematous gastritis precipitated by malignant gastric outlet obstruction from advanced pancreatic ductal adenocarcinoma"],"prefix":"10.12890","volume":"13","author":[{"given":"Yong Yang","family":"Lim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Changi General Hospital, Changi, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10397","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"10.12890\/2026_007418_ref1","doi-asserted-by":"crossref","unstructured":"Matsushima K, Won EJ, Tangel MR, Enomoto LM, Avella DM, Soybel DI. Emphysematous gastritis and gastric emphysema: similar radiographic findings, distinct clinical entities. World J Surg. 2015;39(4):1008\u201317. doi: 10.1007\/s00268-014-2882-7.","DOI":"10.1007\/s00268-014-2882-7"},{"key":"10.12890\/2026_007418_ref2","doi-asserted-by":"crossref","unstructured":"Ono R, Ito R, Yamamoto K, Aoki K, Kobayashi Y. Emphysematous gastritis. BMJ Case Rep. 2022;15(8):e251314. doi: 10.1136\/bcr-2022-251314.","DOI":"10.1136\/bcr-2022-251314"},{"key":"10.12890\/2026_007418_ref3","doi-asserted-by":"crossref","unstructured":"Qasim A, Penikelapate S, Sosa F, Jyala A, Ghazanfar H, Patel H, et al. Emphysematous gastritis: a case series on a rare but critical gastrointestinal condition. Cureus. 2023;15(12):e50409. doi: 10.7759\/cureus.50409.","DOI":"10.7759\/cureus.50409"},{"key":"10.12890\/2026_007418_ref4","doi-asserted-by":"crossref","unstructured":"Aggarwal CS, Dahiya S, Kochhar S, Aggarwal K, Edgecombe L, Jeje T, et al. Emphysematous gastritis: the silent storm within the stomach wall. J Int Med Res. 2025;53(10). doi: 10.1177\/03000605251389384.","DOI":"10.1177\/03000605251389384"},{"key":"10.12890\/2026_007418_ref5","doi-asserted-by":"crossref","unstructured":"Nasser H, Ivanics T, Leonard-Murali S, Shakaroun D, Woodward A. Emphysematous gastritis: a case series of three patients managed conservatively. Int J Surg Case Rep. 2019;64:80\u20134. doi: 10.1016\/j.ijscr.2019.10.003.","DOI":"10.1016\/j.ijscr.2019.09.046"},{"key":"10.12890\/2026_007418_ref6","doi-asserted-by":"crossref","unstructured":"Watson A, Bul V, Staudacher J, Carroll R, Yazici C. The predictors of mortality and secular changes in management strategies in emphysematous gastritis. Clin Res Hepatol Gastroenterol. 2017;41(1):e1\u20137. doi: 10.1016\/j.clinre.2016.02.011.","DOI":"10.1016\/j.clinre.2016.02.011"},{"key":"10.12890\/2026_007418_ref7","doi-asserted-by":"crossref","unstructured":"Birkholz T, Kim GJ, Niehaus H, Conrad-Schnetz K. Non-operative management of Sarcina ventriculi-associated severe emphysematous gastritis: a case report. Cureus. 2022;14(11):e31543. doi: 10.7759\/cureus.31543.","DOI":"10.7759\/cureus.31543"},{"key":"10.12890\/2026_007418_ref8","doi-asserted-by":"crossref","unstructured":"Ogbue OD, Haddad A, Daw H. A rare case of emphysematous gastritis secondary to chemotherapy. Cureus. 2021;13(10):e18895. doi: 10.7759\/cureus.18895.","DOI":"10.7759\/cureus.18895"},{"key":"10.12890\/2026_007418_ref9","doi-asserted-by":"crossref","unstructured":"Kyawzaw L, Emmanuel O, Sandar L. Medical management of emphysematous gastritis. Ann Intern Med Clin Cases. 2022. doi: 10.7326\/aimcc.2022.0799.","DOI":"10.7326\/aimcc.2022.0799"},{"key":"10.12890\/2026_007418_ref10","doi-asserted-by":"crossref","unstructured":"Jenkins JK, Georgiou A, Laugharne M, Meisner S, Cook T. Emphysematous gastritis in a patient with neutropenic sepsis: a case report and literature review with comment on management. 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