Gastric Intramural and Portal Venous Gas Following Blunt Abdominal Injury

Gastric emphysema or pneumatosis is a rare finding. Early endoscopy and urgent laparotomy is advised in post trauma patients. A 29 year old man presented with blunt abdominal injury following a high-speed motorbike crash He complained of abdominal pain and abdomen was distended. CT abdomen revealed air in the gastric wall with disruption of gastric mucosa. He had normal white cell counts, bleeding parameters and blood gases. He was treated conservatively with nasogastric decompression, intravenous analgesics and antibiotics with which he recovered well. Early surgical management is indicated in patients post trauma in whom bowel infarction is suspected. In a stable patient, a negative laparotomy is a major additional stress post trauma - conservative management with close clinical observation is a suitable management alternative.