Objective: In the present case report, we emphasise that gastric necroses should be considered among acute abdominal syndromes, regardless of the aetiology. No clinical, radiological, or pathological finding to explain the gastric necrosis can be detected in some cases. Such cases are referred to as idiopathic gastric necrosis.

Case: A 62-year-old male patient who had stomach ache, nausea, and vomiting for 7 days was evaluated in the emergency ward. It was ascertained from the history of the patient that he had diabetes, hypertension, chronic obstructive pulmonary disease, and below-the-knee dry gangrene. Because standing direct abdominal radiography revealed free air under the diaphragm, and computed tomography revealed generalised intra-abdominal fluid and air, the patient was explored with a pre-diagnosis of organ perforation. A total gastric resection and Roux-en-Y oesophagojejunostomy were performed on the patient.

Discussion: Gastric necrosis is a rare and potentially fatal condition. Several aetiological factors have been identified. Vascularcausesmayinclude arterialembolism-thrombosis, and vasculitides and diabetes due to autoimmune diseases resulting in microcirculatory disorders. Diabetes can affect multiple systems. Especially in diabetic patients, the rate for peripheral vascular disease increases in proportion to the duration. The impaired microcirculation in diabetic patients due to microangiopathy reduces the blood supply to tissues. Tissue necrosis, the end-point of damage, is due to the reduced perfusion.

Conclusion: In the present case report, we emphasise that gastric necroses should be considered among acute abdominal syndromes, regardless of the aetiology, which can be recovered with early intervention, but which have a mortality of up to 90% when intervention is delayed.

Stomach Necrosis Diabetes mellitus