Ohira Shusaku, Okada Yoshito, Ishida Yosuke, Akiyama Sojiro
Department of Emergency Handa City Hospital Handa Aichi Japan.
Department of Surgery Handa City Hospital Handa Aichi Japan.
Acute Med Surg. 2020 Dec 20;7(1):e615. doi: 10.1002/ams2.615. eCollection 2020 Jan-Dec.
Esophageal hiatal hernia is commonly encountered in clinical practice. We describe a case of cardiac compression caused by an esophageal hiatal hernia that resulted in circulatory failure and cardiac arrest.
An 82-year-old woman presented to our hospital with vomiting, which progressed to cardiac arrest in the emergency room after computed tomography (CT) imaging. CT revealed gastric herniation into the mediastinum, with marked cardiac compression. Cardiopulmonary resuscitation was performed, and a nasogastric tube was inserted for gastric decompression, which resulted in the return of spontaneous circulation and subsequent hemodynamic stabilization. However, the patient died of aspiration pneumonia 4 days later.
Gastric decompression can lead to rapid improvements in respiration and circulation in patients with an esophageal hiatal hernia. Nonetheless, to prevent complications, such as those observed in our patient, definitive surgical treatment is warranted.
食管裂孔疝在临床实践中较为常见。我们描述了一例因食管裂孔疝导致心脏受压,进而引起循环衰竭和心脏骤停的病例。
一名82岁女性因呕吐前来我院就诊,在进行计算机断层扫描(CT)成像后,于急诊室进展为心脏骤停。CT显示胃疝入纵隔,伴有明显的心脏受压。进行了心肺复苏,并插入鼻胃管进行胃减压,这使得自主循环恢复,随后血流动力学稳定。然而,患者在4天后死于吸入性肺炎。
胃减压可使食管裂孔疝患者的呼吸和循环迅速改善。尽管如此,为预防并发症,如我们患者中观察到的那些,仍需进行确定性手术治疗。