Lethal mechanisms in gastric volvulus
| Autor: | Roger W. Byard, Kimberley J. Omond |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Stomach Volvulus Perforation (oil well) Mediastinal Shift Peritonitis Diagnosis Differential 03 medical and health sciences 0302 clinical medicine medicine Humans Kyphosis 030216 legal & forensic medicine Gastric volvulus business.industry Cerebral Palsy Health Policy Stomach digestive oral and skin physiology 030208 emergency & critical care medicine Middle Aged medicine.disease Surgery Diaphragm (structural system) Volvulus Issues ethics and legal aspects medicine.anatomical_structure Scoliosis Shock (circulatory) Female Autopsy medicine.symptom Respiratory Insufficiency business Law |
| Zdroj: | Medicine, Science and the Law. 57:39-41 |
| ISSN: | 2042-1818 0025-8024 |
| DOI: | 10.1177/0025802416689764 |
| Popis: | A 55-year-old wheelchair-bound woman with severe cerebral palsy was found at autopsy to have marked distention of the stomach due to a volvulus. The stomach was viable, and filled with air and fluid and had pushed the left dome of the diaphragm upwards causing marked compression of the left lung with a mediastinal shift to the right (including the heart). There was no evidence of gastric perforation, ischaemic necrosis or peritonitis. Removal of the organ block revealed marked kyphoscoliosis. Histology confirmed the viability of the stomach and biochemistry showed no dehydration. Death in cases of acute gastric volvulus usually occurs because of compromise of the gastric blood supply resulting in ischaemic necrosis with distention from swallowed air and fluid resulting in perforation with lethal peritonitis. Hypovolaemic shock may also occur. However, the current case demonstrates an alternative lethal mechanism, that of respiratory compromise due to marked thoracic organ compression. |
| Databáze: | OpenAIRE |
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