Bowel in Chest: Type IV Hiatal Hernia.

نویسندگان

  • William Krause
  • Jennifer Roberts
  • Romel J Garcia-Montilla
چکیده

doi:10.3121/cmr.2016.1332 A man, age 81 years, presented with frequent nausea and non-bloody vomiting for the past week, and a 3-day history of worsening epigastric abdominal pain with no flatus or bowel movements. He was tachycardic (120 bpm) and hypotensive (86/40 mm Hg). Upper abdomen was profoundly tender and distended. Laboratory results were significant for leukocytosis (20 x 103/uL; normals 4.1– 10.9 x 103/uL), acute kidney injury (creatinine 1.8 mg/dL; normals 0.6–1.3 mg/dL), and lactic acidosis (lactate 6.0 mmol/L; normals 0.5–2.1 mmol/L). Chest radiograph demonstrated air-filled loops of the colon over the midline of the lower thorax (figure 1). Abdominal computed tomography confirmed type IV hiatal hernia (figures 2 and 3). The patient received aggressive hemodynamic resuscitation in the intensive care unit. Exploratory laparotomy with hernia reduction and extended right hemicolectomy, due to extensive colonic necrosis, was performed. Gastrostomy tube was placed.

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عنوان ژورنال:
  • Clinical medicine & research

دوره 14 2  شماره 

صفحات  -

تاریخ انتشار 2016