Acil serviste travmaya sekonder tansiyon gastrotoraks: Bir olgu sunumu

Tansiyon gastrotoraks, abdominal içeriðin toraksa yer deðiþtirmesi ve intratorasik bölgeye uygulanan baský sonucu mediastinal kayma ile seyreden klinik bir durumdur. Genellikle doðuþtan veya edinilmiþ (cerrahiye sekonder) diyafragma defekti nedeniyle olup, nadiren travmaya sekonder görülür.Kýrk yaþýnda erkek hasta, araç içi trafik kazasý sonrasý acil servise baþvurdu. Hafif göðüs aðrýsý dýþýnda aktif bir þikayeti yoktu. Oskültasyonda sol akciðer tabanýnda solunum sesleri ile birlikte baðýrsak sesleri duyuldu. Çekilen bilgisayarlý toraks tomografisinde sol taraflý diyafragma hernisi izlendi. Kýsa süre sonra desatürasyon ve juguler venöz dolgunluk geliþen hastaya nazogastrik dekompresyon uygulandý. Ardýndan açýk cerrahi giriþim amaçlý ameliyata alýndý. Akut baþlangýçlý ciddi solunum yetersizliðinin ayýrýcý tanýsýnda travmatik tansiyon gastrotoraks düþünülmelidir. Hýzlý klinik ve radyolojik deðerlendirme ile taný konulabilir.

Tension gastrothorax secondary to trauma in the emergency room: A case report

In tension gastrothorax, the abdominal contents are displaced into the thorax, leading to a mediastinal shift that arises from the pressure placed on the intrathoracic region. This condition is often due to a congenital or acquired (secondary to surgery) diaphragmatic defect and is rarely seen secondary to trauma. A 40-year-old man presented to the emergency department after an in-vehicle traffic accident. He had no active complaint other than mild chest pain. On auscultation, breath sounds were audible in the left lung base and bowel sounds were heard. Computed tomography of the thorax revealed left-sided diaphragmatic hernia. The jugular vein was distended, and the patient became desaturated in the emergency room. Nasogastric decompression was performed, and the saturation improved. The patient underwent open surgery. Traumatic tension gastrothorax should be considered in the differential diagnosis of acute-onset severe respiratory failure. It can be diagnosed by rapid clinical and radiological evaluation.