Chest
Selected ReportsAcute Gastric Dilatation Causing Respiratory Failure and “Tension Pneumothorax” in an Elderly Woman With a Diaphragmatic Hernia
Section snippets
Case Report
An 84-year-old woman, a nonsmoker, was admitted to the intensive care unit of the Hadassah University Hospital because of acute respiratory failure. She had a large diaphragmatic hernia, which had been diagnosed 20 years previously on a routine chest x-ray film. Five years ago, she was hospitalized with unexplained respiratory failure that required mechanical ventilation. Two days prior to her present admission, she developed a mild nonproductive cough with progressive dyspnea but no fever. She
Discussion
In neonates, a large diaphragmatic hernia frequently results in respiratory failure. The most common form giving rise to this complication is the Bochdalek type (posterior), 4 but Morgagnis hernias5 and congenital eventration of the diaphragm8 may also impair respiratory function. Respiratory compromise is primarily due to hypoplasia of the lung tissue due to prolonged pressure in utero from the intrathoracic intestinal contents. In these patients, anatomic correction of the hernia does not
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