J Korean Soc Traumatol.  2006 Dec;19(2):201-205.

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

• Park MR
• Lee JH
• Ahn JY
• Oh BJ
• Kim W
• Lim KS

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.

Keyword

Diaphragm; Blunt injury; Abdominal injury; Viscerothorax; Gastrothorax

MeSH Terms

Abdominal Injuries
Accidents, Traffic
Child
Decompression
Diaphragm
Emergency Service, Hospital
Hemodynamics
Humans
Male
Rupture*
Shock
Viscera
Wounds, Nonpenetrating