[Gastric micropneumatosis: a rare endoscopic entity].

The rarely described gastric micropneumatosis is caused by accumulating air in the mucus membrane. It may associate mainly with Helicobacter pylori positive atrophic gastritis or with pneumatosis due to gas producing bacteria or non-infectious causes. In our case the disorder was diagnosed in a 69 years old patient, taking clopidogrel, living in a nursing home, with history of hypertension, general arteriosclerosis, cerebral infarction, who was admitted to our department because of melaena and hematemesis. Upper endoscopy revealed a map-like, slightly raised, palm-sized area with yellowish spots on the posterior wall of the markedly inflamed stomach at the level of fundus - corpus border. Based on histology findings, that showed empty spaces among corpus glands, 10-20 microm in diameter, with no epithelial lining, the diagnosis was gastric micropneumatosis. The impaired mucosal integrity caused by mesenteric ischaemia and repeated vomiting were supposed as possible etiological factors, because 72 hours after the patient had stopped vomiting, control endoscopy showed regression, and the empty spaces were no more detectable in the histology samples. By this case report the authors would like to draw attention to a seldom diagnosed gastric injury, and discuss the factors that may predispose the development of gastric micropneumatosis.