Gastrothorax is characterized by herniation of the stomach and other abdominal contents into the thoracic cavity either through the oesophageal hiatus or ruptured diaphragm. When gastrothorax causes pulmonary and hemodynamic compromise, due to compression of lungs and mediastinal structures, it is named as tension gastrothorax. Diagnosis of tension gastrothorax is often complicated during late pregnancy, because of unusual presentation, altered physiology, absence of trauma, hesitation about radiation exposure, and rarity of the condition. We report a case of a patient, in her 32nd week of pregnancy, who presented with left tension gastrothorax. Lower segment caesarean section was planned after steroid therapy, with all the preparations for thoracotomy. Intra-operatively, stomach, spleen, and colon were found herniated in the left hemithorax, through a ruptured left hemidiaphragm. Thoracotomy was done immediately after caesarean section, with reduction of herniated contents and repair of the defect in the diaphragm. The patient and her baby were discharged in stable condition 2 weeks after thoracotomy.
Keywords: Tension Gastrothorax, Tension Pneumothorax, Third Trimester Pregnancy, Thoracotomy
Cited in 2 Documents
Takahiro Shoji, Takehiko Tarui, Yasuhiko Kaita, Hiroshi Miyauchi, Hideki Fukushima and Yoshihiro Yamaguchi (2017) A survival case of tension gastrothorax due to hiatal hernia, the key of life-saving is thoracotomy. The American Journal of Emergency Medicine35(1):199.e3. doi: 10.1016/j.ajem.2016.07.043
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