Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

• Published in: BMJ case reports Vol. 13; no. 9; p. e235281
• Main Authors: Asanaru Kunju, Sanjan, Ravindra, Prithvishree, Madabushi Vijay, Ramya Kumar, Pattath Sankaran, Priya
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 13.09.2020; BMJ Publishing Group
• Series: Case report
• Subjects: Abdomen; Abdominal Pain - etiology; Blood pressure; Cardiac arrhythmia; Cardiac Tamponade - diagnosis; Case reports; Chest Tubes; Diagnosis, Differential; Diaphragm (Anatomy); Diaphragm - diagnostic imaging; Diaphragm - pathology; Diaphragm - surgery; Dyspnea - etiology; Electrocardiography; Female; Hernia, Diaphragmatic - diagnosis; Hernia, Diaphragmatic - etiology; Hernia, Diaphragmatic - surgery; Herniorrhaphy - methods; Humans; Hypotension; Hypoxia; Laparotomy; Mortality; Ostomy; Pain; Pneumothorax; Pneumothorax - diagnosis; Pulmonary Embolism - diagnosis; Pulmonary embolisms; Rare Disease; Respiratory Distress Syndrome - diagnosis; Respiratory Distress Syndrome - etiology; Resuscitation - methods; Rupture, Spontaneous - complications; Rupture, Spontaneous - diagnosis; Rupture, Spontaneous - surgery; Small intestine; Stomach; Stomach - diagnostic imaging; Thoracostomy; Thoracotomy - instrumentation; Trauma; Treatment Outcome; Ultrasonic imaging; Ultrasonography; Vomiting; Young Adult; stomach and duodenum; resuscitation; emergency medicine; ultrasonography; adult intensive care
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-235281

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.