Endocrinol Metab.  2011 Dec;26(4):355-359. 10.3803/EnM.2011.26.4.355.

Diabetic Ketoacidosis Associated with Emphysematous Gastritis: A Case Report

• Choi YM
• Seo JW
• Lee WJ
• Park HJ
• Shin JH
• Kang SB
• Lee J
• Kim JH
• Kim SY
• Bae HY

• KMID: 2169269
• DOI: http://doi.org/10.3803/EnM.2011.26.4.355

Abstract

Diabetic ketoacidosis is a serious and demanding medical emergency for the field of endocrinology, and the identification and correction of the precipitating factors is equally important. Many patients of diabetic ketoacidosis show gastrointestinal symptoms as an initial presentation, and coincidental gastrointestinal diseases can be neglected or misdiagnosed. Emphysematous gastritis is a rare and lethal disease in which gas bubbles form in the stomach wall. The predisposing factors include ingestion of corrosive substances, alcohol abuse, diabetes, and immunosuppressive therapy. Thus, it may be difficult to detect emphysematous gastritis early, especially when it is developed in conjunction with diabetic ketoacidosis. We report a case of diabetic ketoacidosis associated with emphysematous gastritis in a young male without medical history.

Keyword

Diabetic ketoacidosis; Emphysematous gastritis

MeSH Terms

Alcoholism
Diabetic Ketoacidosis
Eating
Emergencies
Endocrinology
Gastritis
Gastrointestinal Diseases
Humans
Male
Precipitating Factors
Stomach

Figure

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  Fig. 1 Simple chest X-ray, computed tomography (CT). A. Chest radiography showed pneumomediastinum (arrow). B. Thorax CT showed pneumomediastinum (arrow). C. Abdomen CT showed mottled air bubbles in the stomach wall (arrow) and portal venous system (arrow).

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  Fig. 2 Upper gastrointestinal endoscopy showed extensive ulceration with exudate formation.

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  Fig. 3 A. Follow-up thorax CT showed resolution of pneumomediastinum (arrow). B. Follow-up abdomen CT showed resolution of stomach wall (arrow), and portal venous air.

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