Authors:

Azhar Zainul¹, Scupham Lisa¹ , Karamatic Rozemary¹

1. Department of Gastroenterology, Townsville University Hospital, 100 Angus Smith Drive, Douglas QLD 4814.

Abstract:

A gentleman in his 70s presents with a subacute history of bloating, diarrhoea, nausea and vomiting, dysphagia, and anorexia over the course of several months. This led to significant weight loss, malnutrition, and deconditioning requiring a prolonged hospital admission. Differentials included malignant, infectious, and autoimmune aetiologies. A gastroscopy revealed active chronic gastritis with no evidence of Helicobacter pylori and duodenal biopsy showed mild villi blunting and no increased epithelial lymphocytes with mixed inflammatory infiltrate within the lamina propria. Coeliac serology was negative. Olmesartaninduced enteropathy was eventually suspected, and prompt improvement in symptoms ensued following cessation of the medication. On investigation of his symptoms, a CT scan showed gastric pneumatosis and air in the hepatic portal venous system (HPVS), consistent with previous reported cases of gastric emphysema (GE). This is a rare radiological diagnosis with uncertain mechanisms, likely multifaceted, which requires further explanation in the context of this complex case

Citation:

Azhar Zainul. Exploring the Multifactorial Aetiology of Gastric Emphysema in a complex case of Olmesartan-induced Enteropathy.Clinical Imaging and Case Reports 2024.