ABSTRACT
Gastric pneumatosis is a very rare entity, and of the hollow viscera, the stomach is the least often reported site for intramural gas. To describe a patient with gas in the gastric wall associated with pneumoperitoneum and diffuse ischemic changes of the small and large bowels. Old man with past history of hemodialysis for renal failure and a diffuse vascular atherosclerosis presenting with an acute abdomen. The CT scan of the abdomen revealed a gastric pneumatosis with pneumoperitoneum and complete thrombosis of the coeliac trunk. Laparotomy showed gastric infarction with peritonitis and diffuse changes through the gastrointestinal tract. A therapeutical abstention was decided in agreement with the family. The patient developed septic shock under broad spectrum antibiotic coverage and died after 12 hours of multiple organs failure. Surgeons, internists and gastroenterologists should be aware of the possibility of gastric pneumatosis in some cases. Underlying disease are important to clarify in order to apply the adequate treatment