2019 Volume 52 Issue 12 Pages 703-711
A 59-year-old woman underwent nutritional administration via a nasogastric tube during psychiatric hospitalization for anorexia nervosa. CT examination which was given because of the abdominal pain that occurred on the 8th day after insertion of the nasogastric tube, showed severe edema of the entire gastric wall, air bubbles in the gastric wall, hepatic portal venous gas, mediastinal emphysema, and subcutaneous emphysema. The endoscopic examination showed focal mucosal necrosis in the greater curvature side of the upper gastric body. Total gastrectomy was performed under the diagnosis of portal venous gas from emphysematous gastritis. In this case, the emphysematous gastritis with the portal venous gas developed due to infection from gastric mucosal injury by insertion of the nasogastric tube. At the same time, it was thought that mediastinal emphysema and subcutaneous emphysema occurred due to elevated airway pressure and alveolar rupture caused by stimulation at the time of insertion of gastric tube, with the background of malnutrition and the tissue vulnerability. We report a rare case where it was assumed that these two pathological conditions coincided at the same time.
