Numerous complications of a DH have been reported, including small or large bowel obstruction and strangulation, acute appendicitis with malrotation, splenic torsion, gastric volvulus and perforation, acute pneumothorax and gastrothorax. [10,11,12] Auscultation of bowel sounds over the hemithorax suggests the diagnosis.
Congenital diaphragmatic hernia with gastric volvulus presenting as an acute tension gastrothorax. American Journal of Emergency Medicine 1999;17(1):35-7.
Congenital diaphragmatic hernia complicated by tension gastrothorax during gastroscopy: report of a case.
Chest radiograph showed a massive gastrothorax on the left side with mediastinal shift to the right side and complete collapse of the left lung (Fig.
The NGT was also very useful in decompressing the distended gastrothorax and is in fact the recommended intervention to relieve the respiratory distress.
In another case, the ICD was inserted below the left diaphragm, the acute gastrothorax following blunt chest trauma having being misdiagnosed as a tension pneumothorax (Table III) (Figs 2 and 3).
Complications in patients referred with an ICD in situ Wrong side attempted 1 Extrathoracic 4 Incorrect anatomical site of insertion 3 ICD inserted through stab wound 2 Tube not securely sutured to chest wall 3 Non-functional (tube not deep enough) 10 Tube placed below diaphragm (gastrothorax) 1 Total 24
Delayed presentation of gastrothorax
masquerading as pneumothorax.
But, in our clinical scenario, due to misdiagnosis in the private hospital, our patient ended up with tension gastrothorax with significant mediastinal shift.
Intrathoracic stomach presenting as acute tension gastrothorax. Am J Emerg Med 1999; 17: 370-1.