Tension gastrothorax causing cardiac arrest in a child

Rathinam, Sridhar; Margabanthu, Gomathi; Jothivel, Govindasami; Bavanisanker, Thulasi

doi:10.1016/s1569-9293(02)00064-6

Cited by 11 publications

(13 citation statements)

References 5 publications

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“…[5] Rathinam and colleagues have reported fluid-gas level on the left hemithorax in a pediatric patient with tension gastrothorax. [4] In index case, only findings of tension pneumothorax were seen on chest X-ray.…”

Section: Discussionmentioning

confidence: 93%

“…Therefore, determining the real incidence is difficult. [4] Tension gastrothorax develops through congenital diaphragmatic defects, iatrogenic defects (tube thoracostomy, esophageal interventions, diaphragmatic plication, and etc.) or traumatic diaphragmatic ruptures.…”

Section: Discussionmentioning

confidence: 99%

“…In the diagnosis of such a rare entity, clinical suspicion is very important because there are no pathognomonic findings of diaphragmatic rupture and gastrothorax. [4] Tokur et al Non-traumatic tension gastrothorax in a young lady Clinically, it may mimic tension pneumothorax. Findings such dyspnea, hypotension (secondary to mediastinal vascular compression), tachycardia, intestinal sounds on the left hemithorax may be seen.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, cardiopulmonary arrest may occur due to mediastinal compression and acute venous return failure. [4] Kao Y and colleagues have reported a patient with tension gastrothorax as a late complication of a prior blunt thoracic trauma, who had abdominal distension, epigastric pain and persistent hiccup at the time of admission.…”

Section: Discussionmentioning

confidence: 99%

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Non-traumatic tension gastrothorax in a young lady

Tokur

Demiröz

Sayan

2015

Ulus Travma Acil Cerrahi Derg

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Tension gastrothorax is a very rare but potentially fatal clinical condition in which the stomach that herniates through a diaphragmatic defect into the thorax is massively distended by trapped air. It leads to severe symptoms due to the compression of the lung and mediastinum. A 27-year-old female, who had no prior trauma history, applied to the emergency service with the complaint of respiratory disorder, and was consulted by the department of thoracic surgery. Thorax CT revealed presence of gastrothorax in the left hemithorax. Thus, the patient went into cardiopulmonary arrest and was resuscitated. Emergency thoracotomy was performed, abdominal organs were reduced and diaphragmatic defect was repaired. She was discharged on the fifth postoperative day without any complications.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Non-traumatic tension gastrothorax in a young lady

Tokur

Demiröz

Sayan

2015

Ulus Travma Acil Cerrahi Derg

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“…The acute manifestation may be bleeding and herniation of viscera into the thoracic cavity causing hemodynamic compromise. 1 We present a case of an acute tension viscerothorax that occurred immediately after blunt trauma leading to cardiac and pulmonary compromise.…”

mentioning

confidence: 99%

Tension viscerothorax due to traumatic diaphragmatic rupture

Ekim¹,

Tuncer²,

Özbay³

2008

Ann Saudi Med

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The diaphragm separates the thorax from the abdominal cavity, and trauma to either region may cause hernia of the diaphragm. The sequelae of the diaphragmatic injury may manifest as an acute or chronic presentation. The acute manifestation may be bleeding and herniation of viscera into the thoracic cavity causing hemodynamic compromise.1 We present a case of an acute tension viscerothorax that occurred immediately after blunt trauma leading to cardiac and pulmonary compromise. CASEA 31-year old man was admitted to the Emergency Department of Yuzuncu Yil University Hospital. He was the victim of a traffic accident and sustained injuries to the right lower limb. On admission, the patient had severe respiratory distress (respiratory rate, 43/min), hypotension (85/59 mm Hg), and tachycardia (heart rate, 142 beats per minute). He was cyanotic, and auscultation revealed decreased breath sounds in the left hemithorax. Heart sounds were heard to the right of the sternum. The peripheral pulses were all present and the neurological examination was normal.Initially, the clinical presentation and chest radiograph were misinterpreted as tension pneumothorax in the emergency room. A chest tube was inserted, resulting in no improvement of cardiopulmonary function. The patient was transferred to our department for further evaluation and management. A repeated chest radiograph revealed a large mass in the left hemithorax displacing the heart and mediastinum to the right side (Figure 1). A CT scan confirmed the tension viscerothorax. Repeated attempts to insert a nasogastric tube were unsuccessful. The hematology and emergency routine biochemistry results were within normal limits.He was taken to the operating room immediately. A left thoracotomy was performed through the seventh intercostal space. At exploration, the stomach and omentum were found in the left thoracic cavity herniated through a diaphragmatic rupture, compressing both the heart and lung (Figure 2). The stomach had dilated inside to the left hemithorax. An attempt to insert a nasogastric tube was successful while repositioning the stomach. The stomach was decompressed with the aid of nasogastric tube aspiration. The decompression resulted in immediate improvement in ventilation and oxygenation. The decompressed stomach and omentum were easily reducted following gastric aspiration. A 14-centimeter linear tear in the left hemidiaphragm was oversewn with interrupted non-absorbable sutures (0-polypropyline). Other intraabdominal and intrathoracic organs were uninjured and there was no evidence of hemothorax or pneumothorax. A chest tube was placed in the left thoracic cavity. The incision of the thoracotomy was closed in the standard manner. The hospital course of the patient was somewhat prolonged due to a right femur fracture. At the ninth month of follow-up, he was asymptomatic and had an unremarkable physical examination. DISCUSSIONForceful impact to the upper abdomen due to blunt abdominal trauma creates a sudden increase in intraabdominal pressure that transmits...

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