DOI: 10.36347/sjmcr.2017.v05i12.012

Pages: 850-851

The patient was a 55-year-old man who had fallen from a height of 1.5 m when cutting a tree branch. He complained of face, chest, back, right femur and leg pain. He had hypertension and gastritis. He was diagnosed with cerebral concussion, right 8 and 9th rib fractures, right hemopneumothorax, liver injury with ascites and pelvic and leg fractures by whole computed tomography (CT). He underwent right thoracotomy, and received oxygen and a fentanyl infusion. On the same day, follow-up CT revealed gastric emphysema (GE), air in the gastric-omental vein and the portal vein of the liver with enlargement of the stomach. As he had no abdominal pain and signs of peritoneal stimulation, conservative therapy was selected. He survived and was discharged. A possible mechanism of GE was that massive amount of air associated with the enlargement of stomach due to paralysis, entered the site of an underlying gastric lesion and resulted in the gastric wall being filled with air. This unique case adds one more cause to the list of documented etiologies of GE.