Adenovirus F40/41 Gastroenteritis-Associated Emphysematous Gastritis: A Case Report.

Emphysematous gastritis (EG) is a rare form of gastritis characterized by gastric wall pneumatosis. It is associated with a high mortality rate. Our case report describes a patient with a history of atrial fibrillation treated with apixaban, prior stroke, and schizoaffective disorder who showed epigastric tenderness on examination. However, no peritonitis signs were recorded, and laboratory values revealed high lactate levels and the presence of adenovirus F40/41. Abdominal computed tomography scan showed extensive portal venous gas in the left hepatic lobe of the liver, as well as pneumatosis involving the entire stomach, indicating EG. The diagnosis was histologically confirmed and initially managed medically, which proved inefficacious, necessitating surgical intervention in the form of a laparotomy and esophagojejunostomy with Roux-en-Y reconstruction. This case report suggests a potential association between EG and adenovirus F40/41-induced gastroenteritis, thereby emphasizing the challenging nature of EG. It underscores the need for comprehensive research to enhance our understanding of its underlying causes and effective treatment strategies.