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Asian Cardiovasc Thorac Ann 2007;15:178-179
© 2007 Asia Publishing EXchange Ltd

IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY

Gastric Volvulus after Diaphragm Rupture

Yun-Hen Liu, MD, Yi-Chih Kao, MD, Ming-Ju Hsieh, MD, Yi-Cheng Wu, MD, Po-Jen Ko, MD, Hui-Ping Liu, MD

Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

For reprint information contact: Po-Jen Ko, MD, Tel: 886 3 328 1200 Ext 2118, Fax: 886 3 328 5818, Email: pjko{at}cgmh.org.tw, Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, 5, Fushing Street, Gueishan Shiang, Taoyuan 333 Taiwan.

A 46-year-old male presented with upper abdominal pain and vomiting of a 5-hour duration. He had a prior history of penetrating chest injury 20 years ago. Physical examination revealed soft abdomen with severe tenderness over mid epigastric region.

Chest X-Ray (Figure 1Go) revealed elevation of gastric air and hemidiaphragm suggested the presence of traumatic diaphragmatic hernia. The gastric volvulus and herniation of visceral organ into the left thorax was identified at upper gastrointestinal series (Figure 1Go) and computed tomography (Figure 2Go). He underwent emergent laparotomy with resection of ischemic portion of the fundus. He was discharged 10 days after surgery.


Figure 1
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  		Figure 1. Chest X-Ray revealed elevation of gastric air and hemidiaphragm, upper gastrointestinal series revealed gastric volvulus.

 

Figure 2
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  		Figure 2. CT scan (Axial and coronal) revealed herniation of stomach into the left thoracic cavity.

 





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