Objective: Emphysematous gastritis is an uncommon but severe condition marked by the presence of intramural gas within the gastric wall, typically resulting from gas-forming bacterial infections. This study aims to analyse the radiological presentations and outcomes of three distinct cases to enhance diagnostic accuracy and guide management strategies.

Methods: We performed a retrospective analysis of three patients diagnosed with emphysematous gastritis. Each case was evaluated using various imaging techniques including plain abdominal X-ray, and computed tomography (CT). The radiological findings were correlated with clinical outcomes and treatment approaches.

Results: Radiological evaluations revealed distinctive patterns: (1) Plain X-rays in two patients demonstrated diffuse gas within the gastric wall. (2) CT scans provided detailed insights into the extent of intramural gas, identified associated complications such as pneumoperitoneum, and assessed the involvement of adjacent organs. Clinical management varied; one patient responded well to conservative treatment with antibiotics and supportive care, while the other two required surgical intervention due to complications including perforation and systemic infection.

Conclusion: The imaging features of emphysematous gastritis are critical for early diagnosis and effective management. This case series highlights the utility of imaging modalities in evaluating the severity and extent of the disease, which can significantly influence treatment outcomes. Prompt and accurate radiological assessment is essential for optimizing patient care in this challenging condition.