Cases reported "Hydropneumothorax"

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1/2. Atraumatic perforation of the esophagus: current concepts and report of an additional case.

    Truly atraumatic perforation of the esophagus is extremely rare. One such case with clinical features classic of this entity is reported. Characteristic findings of hydropneumothorax and pneumomediastinum on plain chest film, and the contrast esophagogram confirmed the diagnosis quickly. However, since the patient sought medical help late, with established septicemic shock, only closed chest drainage could be offered which proved grossly inadequate, and the patient died within 24 hours of presentation. As in the literature, this case report suggests that a case of esophageal perforation can easily and quickly be recognized on plain chest film, and that early aggressive surgical intervention in the form of open and wide mediastinal and chest drainage, with or without esophageal repair, resection or exclusion, offers the patients the best chances of survival against this otherwise invariably fatal event.
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keywords = esophagus
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2/2. Incarceration of gastric fundus in a paraesophageal hernia after gastroplasty.

    A tension hydropneumothorax developed suddenly in a 33-year-old woman, 5 days after gastroplasty. The cause was not immediately apparent. Radiologic investigation demonstrated incarceration of the fundus of the stomach together with the stapled pouch in a paraesophageal hernia. Abdominal exploration revealed a blow-out in the wall of the incarcerated fundus. After appropriate repair and management, the patient's course was uncomplicated. This case highlights the need for repairing paraesophageal hernias as soon as they are discovered, particularly during operations that require mobilization of the esophagus and cardia, as in gastroplasty.
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keywords = esophagus
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