Supplementary table 1
Age/Sex / Presenting symptoms/signs / Comorbidities / CT findings / Endoscopic findings / Treatment / Follow-up endoscopy / Outcomes
81 F / Coffee ground emesis / Mason Roux-en-Y gastric bypass; CAD; DM; HTN / CTA: ostial stenosis of celiac, SMA and IMA / Diffuse ischemic-appearing purplish mucosa with oozing ulcers in gastric body / IR stenting for ostial stenosis; gastrectomy for refractory bleeding / n/a / Alive at 3 months f/u
81 M / Abdominal pain; coffee ground emesis / CAD; PVD; AF / CT with IV contrast: portal venous gas; gastric pneumatosis
CTA: ostial stenosis of celiac, SMA and IMA / Diffuse ischemic-appearing purplish and congested mucosa of posterior stomach / IR stenting for SMA stenosis / Complete healing with scarred mucosa at 7 weeks / Alive at 16 months f/u
75 M / Abdominal pain; coffee ground emesis; hypotension / Churg-Strauss vasculitis; COPD / CT without IV contrast: gastric pneumatosis; marked dilatation of the stomach / Diffuse ischemic ulcerations in the fundus and proximal body of stomach; gastric dilation with retained bloody material / Partial gastrectomy for gastric perforation with drainage of abscess / n/a / Died at 28 days post-op from sepsis
57 M / Altered mental status; cardiac arrest (PEA) / Polysubstance abuse; bipolar disorder / CT with IV contrast: pneumatosis intestinalis; patent celiac axis / Edematous and hemorrhagic mucosa with diffuse superficial ulcerations along the greater curvature of proximal and mid-body of the stomach / PPI, antibiotics and NGT decompression / n/a / Died 1 day later with multi-organ failure
54 M / Coffee ground emesis; melena;
hypotension / Post-hepatic artery embolization for liver metastasis from pancreatic islet cell carcinoma / n/a / Large amount of clots with pale, dusky discoloration of the mucosa in the cardia / PPI, antibiotics and NGT decompression / n/a / Died 1 month later due to islet cell tumor
78 M / Abdominal pain; coffee ground emesis; hypotension / Post-op day 3 after Whipple’s procedure for renal cell cancer metastasis to pancreas / n/a / Large ischemic-appearing ulcerated area involving the posterior wall of the body and extending in a circumferential fashion in the antrum / TPN, PPI, antibiotics and NGT / n/a / Alive after 8 years
78 M / High ileostomy output / UC status post total proctocolectomy / CT without contrast: extensive gastric pneumatosis; portal venous gas / Gastric wall erosions; mucosal abnormalities notable for potential necrosis / PPI and antibiotics / Healed mucosa with medium-sized scar along the greater curvature at 8 weeks / Alive at 2 months f/u
67 M / Abdominal pain; anorexia / UC; HTN; hyperlipidemia; ex-smoker / CT with IV contrast: ostial stenosis of celiac and SMA / Patchy white mucosa in the body and antrum with several superficial and linear ulcerations / IR dilatation and stenting for ostial stenosis / Healed scarred mucosa at 11 weeks / Alive at 14 months f/u
73 M / Hematuria; chest discomfort; hypotension / Post-op day 11 Ivor-Lewis procedure for cancer of esophagus; HTN; DM; renal insufficiency; infrarenal aortic aneurysm / CT with IV contrast: anastomotic leak / n/a / Direct surgical exploration and partial gastrectomy for necrotic stomach remnant / n/a / Died 6 months later from esophageal carcinoma
70 M / Altered mental status; hematemesis; hypotension / Hilar cholangiocarcinoma complicating PSC; septic shock; refractory ascites; FTT / CT with IV contrast: thrombus extends from the confluence of SMV and splenic veins through the main portal vein to its bifurcation / Diffuse hemorrhagic and edematous gastric mucosa with bleeding / PPI, antibiotics and NGT decompression / n/a / Died within 1 day due to gastric ischemia along with sepsis and complications of ESLD
53 F / Nausea; vomiting / Paraesophageal hernia / CT with IV contrast: hiatal hernia with incarcerated stomach / n/a / Gastrectomy with gastric ischemia on pathology with hernia repair / n/a / Alive at 2 months f/u
68 F / Abdominal pain; dehydration / HTN; PUD; PVD; partial gastrectomy; excessive weight loss / CTA: high-grade ostial stenosis of celiac with occlusion of SMA and IMA / Multiple large ischemic-appearing ulcerations near the anastomosis; ulcer in the fundus of stomach / TPN; vascular bypass surgery for ostial stenosis / Persistent fundic ulcer at 18 months / Alive at 9 years f/u
47 M / Abdominal pain; hematemesis / Symptomatic type 3 paraesophageal hernia; obesity / CT with IV contrast: large hiatal hernia; hemorrhage within the herniated stomach / Patchy area of mucosal necrosis with ulceration and surrounding gastritis in the fundus / Partial gastrectomy with hernia repair / n/a / Alive at 7 months f/u
80 M / Abdominal pain; hematemesis;
sepsis / HTN; hyperlipidemia / CT with IV contrast: gastric pneumatosis; portal venous gas / Congested, hemorrhagic and ulcerated mucosa in the fundus and greater curvature posterior wall of the body / PPI, antibiotics and NGT / n/a / Alive at 24 months f/u
58 F / Abdominal pain; weight loss / Thromboembolism; pancreatic adenocarcinoma status post distal pancreatectomy with celiac axis resection; DM; hyperlipidemia / CT with IV contrast: contained perforation along distal aspect of lesser curve of the stomach. Celiac axis resection; thrombus of the celiac artery to hepatic artery bypass graft / Congested, hemorrhagic and ulcerated mucosa involving the greater curvature and anterior wall of the body / PPI, TPN / n/a / Died after 79 days from contained perforation of stomach secondary to gastric ischemia
73 M / Abdominal pain; nausea; vomiting / HTN; CVD; DM; hyperlipidemia; large diaphragmatic hernia / CT with IV contrast: intra-thoracic stomach with axial volvulus / Large antral ulcer and multiple smaller ulcers in gastric body and fundus / Gastroplasty with hernia repair / Normal gastric mucosa at 12 months / Alive at 72 months f/u
84 F / Abdominal pain; nausea; vomiting; non-bloody diarrhea / HTN; pyloric stenosis / CT without IV contrast: gastric pneumatosis; portal venous gas / Large superficial ulceration involving the entire greater curvature of the stomach / PPI, antibiotics and NGT / n/a / Alive at 3 months f/u
Abbreviations: AF: atrial fibrillation; BMI: body mass index; CAD: coronary artery disease; COPD: chronic obstructive pulmonary disease; CTA: computerized tomography angiography; DM: diabetes mellitus; EGD: esophagogastroduodenoscopy; ESLD: end stage liver disease; FTT: failure to thrive; HTN: hypertension; IMA: inferior mesenteric artery; IR: interventional radiologic; IV: intravenous; NGT: nasogastric tube; PEA: pulseless electrical activity; PPI: proton pump inhibitor; PUD: peptic ulcer disease; PVD: peripheral vascular disease; SMA: superior mesenteric artery; TPN: total parenteral nutrition; UC: ulcerative colitis