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Choi, Seo, Lee, Park, Shin, Kang, Lee, Kim, Kim, and Bae: Diabetic Ketoacidosis Associated with Emphysematous Gastritis: A Case Report
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2011; 26(4): 355-359.

Published online: 21 December 2011

DOI: https://doi.org/10.3803/EnM.2011.26.4.355

Diabetic Ketoacidosis Associated with Emphysematous Gastritis: A Case Report

Young Min Choi, Jun Won Seo, Woo Jin Lee, Hyeong Jin Park, Ji Hye Shin, Seung Bum Kang1, Jun Lee, Jin Hwa Kim, Sang Yong Kim, Hak Yeon Bae

Department of Internal Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea.

1Department of Medicine, Chosun University Graduate School, Gwangju, Korea.

Corresponding author: Jin Hwa Kim. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chosun University Hospital, Chosun University School of Medicine, 588 Seoseok-dong, Dong-gu, Gwangju 501-717, Korea. Tel: +82-62-220-3011, Fax: +82-62-223-3316, endocrine@chosun.ac.kr

Received 25 June 2011       Accepted 14 September 2011

Copyright © 2011 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Diabetic ketoacidosis, Emphysematous gastritis

Figures and Tables

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).
enm-26-355-g001
Fig. 2
Upper gastrointestinal endoscopy showed extensive ulceration with exudate formation.
enm-26-355-g002
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.
enm-26-355-g003
Table 1
The clinical characteristics of emphysematous gastritis in Korean
enm-26-355-i001

Anti, antibiotics; op, operation; Px, prognosis; Ref, reference; Tx, treatment.

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