Gastric emphysema is caused by a mucosal disruption of stomach, which is leading to the dissection of air into the wall. A 24-year-old man admitted to our hospital with vomiting, abdominal distension, and pain. Abdominal computed tomography showed severe gastric distension, air within the gastric wall, and a compressed third segment of the duodenum by superior mesenteric artery (SMA). The upper endoscopy revealed multiple geographic ulcers in the gastric body and marked dilatation of the second segment of duodenum and a collapsed third segment. Based on these findings and his symptoms, the patient was diagnosed as having gastric emphysema related with SMA syndrome. He improved after the nasogastric decompression, jejunal feeding and administration of antibiotics. We report a rare case of gastric emphysema related with SMA syndrome. He was managed successfully with medical treatment and nutritional support.

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• Gastric Pneumatosis and Its Gastrofibroscopic Findings in Life-Threatening Superior Mesenteric Artery Syndrome Complicated by Anorexia Nervosa in a Child
  Jeong Ho Seo, Inwook Lee, Saehan Choi, Seung Yang, Yong Joo Kim
  Pediatric Gastroenterology, Hepatology & Nutrition.2023; 26(5): 284.     CrossRef