scholarly journals Delayed diaphragmatic rupture presenting with acute gastric volvulus

2014 ◽  
Vol 96 (7) ◽  
pp. e17-e19 ◽  
Author(s):  
JML Williamson ◽  
R Macleod ◽  
A Hollowood
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Gastric Volvulus ◽  
Diaphragmatic Rupture ◽  
Motorcycle Accident ◽  
Thoracic Computed Tomography ◽  
Acute Gastric Volvulus ◽  
Hospital Cardiac Arrest

Gastric volvulus is a rare complication of diaphragmatic rupture. We report the case of an 82-year-old man who presented following an out-of-hospital cardiac arrest. Chest radiography and thoracic computed tomography revealed an acute gastric volvulus and a chronic diaphragmatic hernia containing transverse colon and abdominal viscera. He had complained of retching and associated epigastric pain prior to collapse, and had sustained a motorcycle accident approximately 60 years earlier. Insertion of a nasogastric tube was unsuccessful (completing Borchardt’s diagnostic triad) and his condition prevented both operative and endoscopic reduction of his volvulus. He died soon afterwards.

Abstract 407: Utility of Abnormal Head Computed Tomography in Predicting Outcome in Out of Hospital Cardiac Arrest Victims Resuscitated and Subsequently Placed on Targeted Temperature Management

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Michael Bernett ◽  
Robert A Swor
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Survival Analysis ◽  
Interrater Reliability ◽  
Targeted Temperature Management ◽  
Neurologic Outcome ◽  
Temperature Management ◽  
Radiology Reports ◽  
Head Computed Tomography ◽  
Hospital Cardiac Arrest

Introduction: Head computed tomography (HCT) is often performed to assess for hypoxic-ischemic brain injury in resuscitated out of hospital cardiac arrest (OHCA) patients. Our primary objective was to assess whether cerebral edema (CE) on early HCT is associated with poor survival and neurologic outcome post OHCA. Methods: We included subjects from a prospectively collected cardiac arrest database of OHCA adult patients who received targeted temperature management (TTM) at two academic suburban hospitals from 2009-Sept-2018. Cases were included if a HCT was performed in the emergency department (ED). Patient demographics and cardiac arrest variables were collected. HCT results were abstracted by study authors from radiology reports. HCT findings were categorized as no acute disease, evidence of CE, or excluded (bleed, tumor, stroke). Outcomes were survival to discharge or cerebral performance scores (CPC) at discharge of three or four (poor neurologic outcome). Descriptive statistics, univariate, multivariate, survival, and interrater reliability analysis were performed. Results: During the study period, there were 425 OHCA, 277 cases had ED HCTs performed; 254 cases were included in the final survival analysis. Patients were predominately male, 189 (65.0%), average age 60.9 years, average BMI of 30.5. Of all cases, 44 (15.9%) showed CE on CT. Univariate analysis demonstrated that CE was associated with 9.2-fold greater odds of poor outcome (OR: 9.23; 95% CI 1.73, 49.2), and 9.1-fold greater odds of death (OR: 9.09: 95% CI 2.4 33.9). In adjusted analysis, CE was associated with 14.9-fold greater odds of poor CPC outcome (AOR: 14.9, 95% CI, 2.49, 88.4), and 13.7-fold greater odds of death (AOR: 13.7, 95% CI, 3.26, 57.4). Adjusted survival analysis demonstrated that patients with CE on HCT had 3.6-fold greater hazard of death than those without CE (HR: 3.56: 95% CI 2.34, 5.41). Interrater reliability demonstrated excellent agreement between reviewers for CE on HCT (κ = 0.86). Conclusion: The results identify that abnormal HCTs early in the post-arrest period in OHCA patients are associated with poor rates of survival and neurologic outcome. Prospective work is needed to confirm whether selection bias or other variables confound this association.

Epigastric Pain due to Acute Gastric Volvulus

2019 ◽  
Vol 57 (6) ◽  
pp. e185-e186
Author(s):  
Anish Vinit Patel ◽  
Frank J. Senatore ◽  
Abhishek Bhurwal
Keyword(s):  
Epigastric Pain ◽  
Gastric Volvulus ◽  
Acute Gastric Volvulus

scholarly journals Acute Gastric Volvulus on Hiatal Hernia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Abdessamad EL KAOUKABI ◽  
Mohamed MENFAA ◽  
Samir HASBI ◽  
Fouad SAKIT ◽  
Abdelkrim CHOHO
Keyword(s):  
Hiatal Hernia ◽  
Gastrointestinal Endoscopy ◽  
Epigastric Pain ◽  
Gastric Volvulus ◽  
Upper Gastrointestinal Endoscopy ◽  
Rare Entity ◽  
Midline Laparotomy ◽  
Acute Gastric Volvulus ◽  
Upper Abdominal ◽  
Upper Gastrointestinal

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

scholarly journals Acute mesenteroaxial gastric volvulus on computed tomography

2013 ◽  
Vol 17 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Aadil Ahmed
Keyword(s):  
Computed Tomography ◽  
Intestinal Obstruction ◽  
Gastric Volvulus ◽  
Different Types ◽  
Acute Gastric Volvulus ◽  
Life Threatening ◽  
Ct Features

Acute gastric volvulus is a rare, but potentially life-threatening, cause of upper gastro-intestinal obstruction. The diagnosis can prove clinically challenging, and hence there is increased reliance on imaging. There are different types of gastric volvulus, with the variant presented in our case being the less commonly encountered mesenteroaxial gastric volvulus. Some of the CT features of gastric volvulus are described, and the usefulness of CT in assisting with the diagnosis is highlighted.

Early computed tomography in victims of non-traumatic out-of-hospital cardiac arrest

2015 ◽  
Vol 11 (2) ◽  
pp. 237-243 ◽  
Author(s):  
Martin Christ ◽  
Katharina Isabel von Auenmueller ◽  
Jan Peter Noelke ◽  
Benjamin Sasko ◽  
Scharbanu Amirie ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Arrest ◽  
Hospital Cardiac Arrest

scholarly journals An Unusual Case of Acute Dyspnoea: Acute Intrathoracic Gastric Volvulus with Probable Tension Gastrothorax

2021 ◽  
Author(s):  
Jean Bosco Masabarakiza ◽  
Lingna Zhu ◽  
Yilmaz Gorur ◽  
Benoît Cardos ◽  
Noel Lorenzo-Villalba ◽  
...  
Keyword(s):  
Unusual Case ◽  
Rare Complication ◽  
Gastric Volvulus ◽  
Longitudinal Axis ◽  
Gastric Distension ◽  
Haemodynamic Instability ◽  
Acute Dyspnoea ◽  
Mediastinal Shift ◽  
Acute Gastric Volvulus ◽  
Tension Gastrothorax

Acute gastric volvulus is a rare complication affecting 4% of hiatal hernias. It is described as an abnormal rotation of the stomach around a transverse or longitudinal axis and can be intra-abdominal or intrathoracic. Intrathoracic gastric volvulus can lead to tension gastrothorax, which is defined as the presence of a massive gastric distension in the chest cavity causing a mediastinal shift with haemodynamic instability and a risk of cardiorespiratory arrest. We report a case of intrathoracic gastric volvulus with probable tension gastrothorax. Early diagnosis of gastrothorax with computed tomography and immediate insertion of a nasogastric tube resulted in rapid clinical improvement. Surgical intervention is the treatment of choice.

scholarly journals Gastric perforation following improper cardiopulmonary resuscitation in out-of-hospital cardiac arrest

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Guang-Ju Zhou ◽  
Pin Jin ◽  
Shou-Yin Jiang
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Gastric Perforation ◽  
Rare Complication ◽  
Emergency Laparotomy ◽  
Emergency Medical Service Personnel ◽  
Mortality And Morbidity ◽  
The Public ◽  
Creative Commons ◽  
Hospital Cardiac Arrest

Gastric perforation is a rare complication of cardiopulmonary resuscitation (CPR), mostly resulting from incorrect airway management. If left unrecognized, it is associated with high mortality and morbidity. We present a case of gastric perforation after improper CPR. A 56-year-old drunken male was sent to the emergency department due to coma after fall onto the ground. He was thought to have cardiac arrest at scene and was saved with CPR maneuver by his friends who has never been trained before. He was taken to the hospital by emergency medical service personnel and presented with abdominal distention and extensive pneumoperitoneum. Emergency laparotomy was performed which revealed gastric perforation at the lesser curvature of the stomach. The laceration was repaired without any difficulty and the patient was discharged home without any neurological deficit. The aim of this report is to remind the public and emergency physicians that gastric perforation should be suspected in patients with distended abdomen and pneumoperitoneum after CPR. Because the most common risk factor for CPR-related gastric perforation is the bystander-provided resuscitation, it is encouraged for the public to take formal CPR training. doi: https://doi.org/10.12669/pjms.36.2.1363 How to cite this:Zhou GJ, Jin P, Jiang SY. Gastric perforation following improper cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Rapidly Progressive Pulmonary Apical Fibrosis and Parenchymal Destruction in a Patient with Ankylosing Spondylitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hasan Ulusoy ◽  
Nazmiye Tibel Tuna ◽  
Aslı Tanrivermis Sayit
Keyword(s):  
Computed Tomography ◽  
Ankylosing Spondylitis ◽  
Rare Complication ◽  
Granulomatous Inflammation ◽  
Pulmonary Involvement ◽  
High Resolution Computed Tomography ◽  
Thoracic Computed Tomography ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right

Pulmonary apical fibrosis is a rare complication of ankylosing spondylitis (AS). The essential characteristics of this lesion are its very slow progression and frequently asymptomatic nature. Herein, we are presenting a patient with AS who rapidly developed pulmonary apical fibrosis in a 3-year period despite decreased musculoskeletal pains. The 60-year-old male applied with complaints of progressively increasing cough in the recent two years, dyspnea, and fatigue. He had no chronic disease except AS. He had no continuous medication except nonsteroid anti-inflammatory drugs for 2-3 days monthly since his musculoskeletal pains decreased in the recent years. His physical examination revealed reduced breath sounds in the upper zones of the right lung. Chest X-ray revealed increased diffuse opacity in the upper zones of the right lung. Thoracic high-resolution computed tomography showed a consolidation accompanied with traction bronchiectases compatible with chronic fibrosis in the upper lobe of the right lung. However, thoracic computed tomography of the patient performed 3 years ago did not reveal pulmonary apical fibrosis and parenchymal destruction. Biopsy revealed no finding of malignancy, granulomatous inflammation, or vasculitis. The results of cultures were negative. So, the patient was diagnosed as pulmonary involvement of AS, which developed in a 3-year period. This case has shown that extra-articular complications may continue to develop in patients with AS even if their musculoskeletal complaints have subsided. So, patients with AS should be followed up regularly with systemic examinations.

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