Ghandour Richard, Ejbeh Sarkis, Maalouf Pierre, Sayegh Fadlo, El Masri Shafica, El Assaad Hadi, Moussa Elie, Adaimi Frederic
General Surgery Resident, Notre Dame University Hospital, Jounieh, PO Box 7, Lebanon.
Head of the Cardiothoracic Surgery Department, Notre Dame University Hospital, Jounieh, Lebanon.
Trauma Case Rep. 2020 Jun 28;28:100316. doi: 10.1016/j.tcr.2020.100316. eCollection 2020 Aug.
Traumatic gastrothorax, or stomach herniation into the chest post-trauma, is a rare but dangerous condition that can lead to respiratory distress and obstructive shock. Its diagnosis is challenging and requires a high index of suspicion. Immediate stomach decompression is an important, often life-saving step of the treatment, prior to definitive surgical repair. We report herein the case of a 59 year-old female patient, who was involved in a severe motor vehicle accident resulting in multiple injuries. Her right-sided gastrothorax, manifesting as solely nausea at first, was only diagnosed 16 days after trauma, intraoperatively. Worse, her herniated stomach had ruptured within the right pleural cavity causing pneumothorax, spillage of contents and pleuritis. It was an erroneous radiological diagnosis of right lung necrosis which halted surgical management. Right gastrothorax has never been reported previously. This article also reviews the condition's pathophysiology, along with diagnostic and therapeutic modalities, and sheds light on the importance of its early recognition and treatment.
创伤性胃胸疝，即创伤后胃疝入胸腔，是一种罕见但危险的病症，可导致呼吸窘迫和梗阻性休克。其诊断具有挑战性，需要高度的怀疑指数。在进行确定性手术修复之前，立即进行胃减压是治疗的重要步骤，往往能挽救生命。我们在此报告一例59岁女性患者，她遭遇了严重的机动车事故，导致多处受伤。她的右侧胃胸疝起初仅表现为恶心，直到创伤后16天在手术中才被诊断出来。更糟糕的是，她疝入的胃在右胸腔内破裂，导致气胸、内容物溢出和胸膜炎。最初因误诊为右肺坏死而暂停了手术治疗。此前从未有过右侧胃胸疝的报道。本文还回顾了该病症的病理生理学、诊断和治疗方法，并阐明了早期识别和治疗的重要性。
