Tension Gastrothorax in Diaphragmatic Injuries: The Incidence and Case Series on a Trauma Center Level I of Northern University Based Hospital in Thailand

Authors

  • Tidarat Jirapongcharoenlap Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Narain Chotirodniramit Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Kaweesak Chittawatanarat Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  • Kamtone Chandacham Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Keywords:

Tension gastrothorax, diaphragmatic injury, life threatening condition, multiple injuries

Abstract

Background: Tension gastrothorax is a rare complication but life-threatening condition in case of diaphragmatic injury. However, there was no report on this condition in Thailand. Therefore, the objective of this study was to find the incidence and describe tension gastrothorax in blunt diaphragmatic injuries in our setting.

Materials and Methods: We reviewed a five-year retrospective data from a trauma center level I of Northern University-based hospital in Thailand. The baseline data, mechanism of injury, and radiologic study results were collected. Details of cases were described and summarized.

Results: During the five-year period, there were 53 cases of diaphragmatic injury and only 3 (5.7%) suffered from tension gastrothorax. All the patients had the same mechanism of injury (the blunt injury from high-speed vehicle collisions). The pelvic fractures were the associated injuries of all patients. All of the cases could be identified the condition by chest radiography. One patient had a miss diagnosis on initial diagnosis as tension pneumothorax. The decompression of stomach by nasogastric tube was an initial adjunctive intervention during resuscitation. The emergency surgery was necessary in cases of severe hemodynamic and respiratory compromise as well as non-success of decompression of the gastric volume.

Conclusion: Tension gastrothorax is a rare life threatening condition in diaphragmatic injury. Severe blunt injury with pelvic fracture is common mechanism and concomitant injury. The gastric decompression with nasogastric tube is an initial adjunctive therapy during resuscitation.

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Published

2018-06-30

How to Cite

1.
Jirapongcharoenlap T, Chotirodniramit N, Chittawatanarat K, Chandacham K. Tension Gastrothorax in Diaphragmatic Injuries: The Incidence and Case Series on a Trauma Center Level I of Northern University Based Hospital in Thailand. Thai J Surg [Internet]. 2018 Jun. 30 [cited 2024 Nov. 22];39(3):88-94. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/221372

Issue

Vol. 39 No. 3 (2018): July - September

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.