Diaphragmatic hernias are rare and mostly congenital, rarely spontaneous. Perforation and other complications of diaphragmatic hernias are even rarer and associated with significant morbidity and ...mortality. We report a patient presenting to the emergency department with features of empyema requiring intercostal drainage. However, on clinical worsening, radiological imaging showed features of diaphragmatic hernia and a subsequent thoracostomy revealed a herniated gastric perforation. Such cases are very rare and need a high index of suspicion for the diagnosis and early appropriate surgical management. Otherwise, it is associated with very high rates of mortality.
We report a case of intrathoracic gastric perforation within a hiatal hernia in an 82-year-old female patient who underwent successful emergency surgery. The patient with known diagnosis of hiatal ...hernia was transferred to the emergency department for management of hematemesis. Contrast-enhanced computed tomography revealed gastric perforation in the thoracic cavity with extravasation of contrast medium in the gastric mucosa, and we started emergency laparoscopic surgery. During the operation we detected a perforation (about 2 cm) accompanied by bleeding at the anterior gastric wall in close proximity to the esophagogastric junction. We could not safely dissect the hernia sac owing to adhesions; therefore, we performed laparotomy with left thoracotomy, followed by suture closure and coverage of the perforated area, with suture reduction of the hernia orifice. The patient required intensive postoperative care ; however, oral intake was resumed on postoperative day 15, and she was discharged on postoperative day 28. Gastric perforation within a hiatal hernia is rare but potentially fatal ; prompt surgical intervention is warranted in such cases.
Nasogastric (NG) tube insertion is a common and routine procedure that is performed for various purposes. Gastric perforations caused by NG tubes are rare but potentially life-threatening. We report ...a rare case involving a delayed gastric perforation caused by an NG tube in an adult with end-stage heart failure.
Accidental esophageal intubation is a preventable human error that complicates airway management and continues to occur despite advances in medical devices. Perforation of the stomach has been ...associated with esophageal intubation in several case reports. This report presents a case of an elderly woman suspected of having COVID-19-related pneumonia. She was intubated due to respiratory dysfunction. In the initial few minutes, the patient became desaturated, leading to a second intubation. An hour later, the patient’s abdomen was distended, and the chest computed tomography (CT) showed a massive pneumoperitoneum. During laparotomy, a 6 cm long rupture was found in the lesser curvature, which was attributed to accidental esophageal intubation. To avoid such a fatal condition, it is imperative for physicians to ensure the correct positioning of the endotracheal tube. To achieve this goal, further investigation into readily available and highl y sensitive techniques is recommended.
Spontaneous gastric perforation is not a very common entity. If not suspected and managed in time, this is uniformly fatal. Although documented as early as in1825 exact pathology remains unclear even ...to date. A case of spontaneous rupture in a term neonate is being presented as a case report.J Nepal Paediatr Soc 2015;35(3):301-303.
Doxycycline-Induced Gastric Perforation Hong, Yeahwa; Staniorski, Christopher; Pollack, Dean ...
The American surgeon,
11/2023, Letnik:
89, Številka:
11
Journal Article
Recenzirano
Esophageal and gastric mucosal injuries are well-documented adverse effects of doxycycline leading to odynophagia, chest pain, and abdominal pain. There are no clear diagnostic criteria for such ...adverse effects; hence, the diagnosis depends heavily on thorough history. There is a paucity of literature describing life-threatening complications from doxycycline-induced mucosal injury, such as hemorrhage and perforation. We present the first case report describing a gastric perforation from doxycycline use.
Hydrogel bioadhesives have emerged as one of the most promising alternatives to sutures and staples for wound sealing and repairing, owing to their unique advantages in biocompatibility, mechanical ...compliance, and minimally invasive manipulation. However, only a few hydrogel bioadhesives have been successfully used for gastric perforation repair, due to their undesirable swelling when in direct contact with extremely acidic gastric fluids, and are thereby accompanied by a gradually deteriorating adhesion performance. Herein, an acid‐tolerant hydrogel (ATGel) bioadhesive is developed, which integrates two distinct components, an acid‐tolerant hydrogel substrate and an adhesive polymer brush layer. The ATGel bioadhesive can form instant, atraumatic, fluid‐tight, and sutureless sealing of gastric perforation, and enable robust biointerfaces in direct contact with gastric fluids, addressing the key limitations with sutures and commercially‐available tissue adhesives. Moreover, in vivo investigation on gastric perforation of rat model validates the proposed acid‐tolerant bioadhesion, and identifies the mechanisms for accelerated gastric perforation repair through alleviated inflammation, which suppresses fibrosis and enhances angiogenesis.
A kind of synthetic hydrogel bioadhesive, featuring superior acid‐tolerance, instant and robust bioadhesion, enables accelerated gastric perforation repair.
An 80-year-old woman presented to her previous doctor complaining of fever and chills. Abdominal computed tomography (CT) showed a 20-mm-long, linear foreign body from the lesser omentum into the ...liver, which was suspected to be a migrated fish bone. Antibiotic therapy was started, and the patient was referred to our hospital for drainage. Elective drainage was planned after the inflammation subsided. The inflammation flared up after it had subsided, and CT showed an abscess in the lesser omentum ; a linear shadow suggestive of a fish bone was observed inside it and the liver abscess. Laparoscopic drainage of the abscess and foreign body removal with endoscopy were performed. Intraoperative endoscopy confirmed that the mucosal surface of the gastrointestinal tract was maintained. The patient's postoperative course was good, and the abscesses disappeared. Even for intra-abdominal abscesses caused by fish bones, which are difficult to detect intraoperatively, laparoscopic surgery combined with intraoperative endoscopy made it possible to safely perform drainage and remove the foreign body while confirming the positional relationships of the mucosal surface on the gastrointestinal tract, the abscess, and the foreign body.
A 29-year-old woman presented with a 3-year history of postprandial pain and a 2-day history of stomachache and nausea. Thoracoabdominal computed tomography revealed prolapse of the dilated stomach ...into the left thoracic cavity. Emergent laparotomy was performed several hours after hospitalization, because the patient was hemodynamically unstable in a state of shock. Intraoperatively, we observed that most of the stomach had prolapsed into the left thoracic cavity through a left-sided diaphragmatic hernia defect. Contaminated ascitic fluid and pleural effusion spread to the thoracic cavity through this stomach perforation. We removed the ischemic and perforated portions of the stomach and subsequently closed the gastric and diaphragmatic defects. We diagnosed the diaphragmatic defect as a Bochdalek hernia. The patient developed thoracic empyema, preperitoneal abscess, and surgical wound infection. However, these postoperative complications resolved following treatment, and she was discharged 31 days after admission. We report a case of Bochdalek hernia with gastric perforation along with a discussion of the relevant literature.
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