Emphysematous Gastritis in a Chronic Alcohol User: A Case of Gastric Pneumatosis With Suspected Infectious Etiology

Emphysematous gastritis (EG) is a rare but potentially fatal form of gastric pneumatosis caused by gas-forming organisms infiltrating the gastric wall, often in the context of mucosal injury or systemic vulnerability such as chronic alcohol use. We present the case of a 55-year-old male with a history of daily alcohol consumption who arrived with severe epigastric pain and over 100 episodes of vomiting in a single day. Laboratory findings revealed leukocytosis, electrolyte imbalances, and acute kidney injury, while CT imaging showed gas within the gastric wall, consistent with EG. The patient responded favorably to conservative management, including intravenous antibiotics, proton pump inhibitors, fluid resuscitation, and symptomatic care. Although microbiological confirmation was not obtained, the clinical course strongly suggested an infectious etiology. This case highlights the importance of distinguishing EG from gastric emphysema, initiating early empirical therapy, and addressing underlying risk factors such as alcohol use to improve outcomes.