An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review
A diaphragmatic hernia is a protrusion of the abdominal contents into the negative pressure thoracic cavity through a congenital or acquired diaphragmatic defect. Generally, acquired diaphragmatic hernia is a rare, life-threatening condition that usually follows blunt/penetrating trauma or an iatrog...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | SAGE Open Medical Case Reports |
| Online Access: | https://doi.org/10.1177/2050313X221140241 |
| _version_ | 1811186549479440384 |
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| author | Selvakumar Jegannathan Paramasivam Senthil Purushothaman Ali Al Bshabshe Mohammed Jameel Eltaher Osman Nasser Mohammed Alwadai Naif Sulaiman Omprakash Palanivel |
| author_facet | Selvakumar Jegannathan Paramasivam Senthil Purushothaman Ali Al Bshabshe Mohammed Jameel Eltaher Osman Nasser Mohammed Alwadai Naif Sulaiman Omprakash Palanivel |
| author_sort | Selvakumar Jegannathan Paramasivam |
| collection | DOAJ |
| description | A diaphragmatic hernia is a protrusion of the abdominal contents into the negative pressure thoracic cavity through a congenital or acquired diaphragmatic defect. Generally, acquired diaphragmatic hernia is a rare, life-threatening condition that usually follows blunt/penetrating trauma or an iatrogenic cause, resulting in the diaphragmatic rupture, accompanied by the herniation of abdominal visceral organs. We report a 47-year-old male construction worker who sustained a fall from a height of about 30 feet height. He presented with hypoxia initially and, after a primary survey, was found to have a traumatic rupture of the diaphragm with herniation of the stomach and abdominal contents, causing signs of obstructive shock. After adequate resuscitation in the Emergency Department, he was rushed to operating room. There, he suffered two very short pulseless electrical activity cardiac arrests. Therefore, an emergency anterolateral thoracotomy was done, and it was extended into laparotomy to reduce the abdominal contents through the diaphragmatic tear of 12 cm, which restored the spontaneous circulation. He recovered eventually, despite chest infections and pulmonary atelectasis, and was discharged on the 28th day and remained in good condition during the outpatient visit. Tension gastrothorax or viscerothorax is rare, but an under-recognized cause of cardiac arrest in the trauma setting necessitates a vigilant evaluation and early suspicion to prevent a catastrophic outcome. This case report emphasizes the inclusion of tension viscero or abdominal thorax as one of the recognizable causes of a pulseless electrical activity cardiac arrest. |
| first_indexed | 2024-04-11T13:47:21Z |
| format | Article |
| id | doaj.art-712977398d7c4643936c8c45c7bfaca1 |
| institution | Directory Open Access Journal |
| issn | 2050-313X |
| language | English |
| last_indexed | 2024-04-11T13:47:21Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medical Case Reports |
| spelling | doaj.art-712977398d7c4643936c8c45c7bfaca12022-12-22T04:20:57ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2022-11-011010.1177/2050313X221140241An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature reviewSelvakumar Jegannathan Paramasivam0Senthil Purushothaman1Ali Al Bshabshe2Mohammed Jameel Eltaher Osman3Nasser Mohammed Alwadai4Naif Sulaiman5Omprakash Palanivel6Emergency Care Consultant, Department of Emergency Care, Aseer Central Hospital, Abha, Saudi ArabiaDean, Chettinad School of Physiotherapy, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam, IndiaIntensive Care Consultant, Aseer Central Hospital & Professor, Department of Medicine/Critical Care, College of Medicine, King Khalid University, Abha, Saudi ArabiaEmergency Care Consultant, Department of Emergency Care, Aseer Central Hospital, Abha, Saudi ArabiaConsultant Respiratory Therapist, Department of Respiratory Care, Intensive Care unit, Aseer Central Hospital, Abha, Saudi ArabiaConsultant Respiratory Therapist, Department of Respiratory Care, Intensive Care unit, Aseer Central Hospital, Abha, Saudi ArabiaResearch Scholar, Chettinad School of Physiotherapy, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Kelambakkam, IndiaA diaphragmatic hernia is a protrusion of the abdominal contents into the negative pressure thoracic cavity through a congenital or acquired diaphragmatic defect. Generally, acquired diaphragmatic hernia is a rare, life-threatening condition that usually follows blunt/penetrating trauma or an iatrogenic cause, resulting in the diaphragmatic rupture, accompanied by the herniation of abdominal visceral organs. We report a 47-year-old male construction worker who sustained a fall from a height of about 30 feet height. He presented with hypoxia initially and, after a primary survey, was found to have a traumatic rupture of the diaphragm with herniation of the stomach and abdominal contents, causing signs of obstructive shock. After adequate resuscitation in the Emergency Department, he was rushed to operating room. There, he suffered two very short pulseless electrical activity cardiac arrests. Therefore, an emergency anterolateral thoracotomy was done, and it was extended into laparotomy to reduce the abdominal contents through the diaphragmatic tear of 12 cm, which restored the spontaneous circulation. He recovered eventually, despite chest infections and pulmonary atelectasis, and was discharged on the 28th day and remained in good condition during the outpatient visit. Tension gastrothorax or viscerothorax is rare, but an under-recognized cause of cardiac arrest in the trauma setting necessitates a vigilant evaluation and early suspicion to prevent a catastrophic outcome. This case report emphasizes the inclusion of tension viscero or abdominal thorax as one of the recognizable causes of a pulseless electrical activity cardiac arrest.https://doi.org/10.1177/2050313X221140241 |
| spellingShingle | Selvakumar Jegannathan Paramasivam Senthil Purushothaman Ali Al Bshabshe Mohammed Jameel Eltaher Osman Nasser Mohammed Alwadai Naif Sulaiman Omprakash Palanivel An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review SAGE Open Medical Case Reports |
| title | An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review |
| title_full | An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review |
| title_fullStr | An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review |
| title_full_unstemmed | An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review |
| title_short | An unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under-recognized cause of cardiac arrest due to a fall from a height: A case report and literature review |
| title_sort | unusual presentation of acute diaphragmatic hernia complicated by tension gastrothorax an under recognized cause of cardiac arrest due to a fall from a height a case report and literature review |
| url | https://doi.org/10.1177/2050313X221140241 |
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