Browse > Article

A Case of Tension Viscerothorax : A Rare Complication of Diaphragmatic Rupture after Blunt Abdominal Trauma  

Park, Maeng Real (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lee, Jae Ho (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Ahn, Ji Yoon (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Oh, Bum Jin (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Kim, Won (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Lim, Kyoung Soo (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
Publication Information
Journal of Trauma and Injury / v.19, no.2, 2006 , pp. 201-205 More about this Journal
Abstract
Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.
Keywords
Diaphragm; Blunt injury; Abdominal injury; Viscerothorax; Gastrothorax;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Ramos CT, Koplewiz BZ, Babyn PS, Manson PS, Ein SH. What have we learned about traumatic diaphragmatic hernias in children? J Pediatr Surg 2000;35:601-4   DOI   ScienceOn
2 Shapiro MJ, Heiberg E, et al. The unreliability of CT scans and initial chest radiographs in evaluating blunt trauma induced diaphragmatic rupture. Clin Radiol 1996;51:27-30   DOI   ScienceOn
3 Bamgbade OA. Management of tension gastrothorax. Resuscitation 2006;70:293-4   DOI   ScienceOn
4 Slater RG. Tension gastrothorax complicating acute traumatic diaphragmatic rupture. J Emerg Med 1992;10:25-30   DOI   ScienceOn
5 David HA. Blunt diaphragmatic injury in a 7-yearold girl. J Emerg Med 2002;23:39-42   DOI   ScienceOn
6 Horst M, Sacher P, Molz G, Willi UV, Meuli M. Tension gastrothorax. J Pediatr Surg 2005;40:1500-4   DOI   ScienceOn
7 Amerian College of Surgeons. Advanced trauma and life support manual. Chicago: American College of Surgeons, 1997
8 Shah R, Sabanathan S, Merans AJ, et al. Traumatic rupture of the diaphragm. Ann Thorac Surg 1995;60:1444-9   DOI   ScienceOn
9 McCann B, O'Gara A. Tension viscerothorax: an important differential for tension pneumothorax. Emerg Med J 2005;22:220-1   DOI   ScienceOn