Gastropleural fistula: an unusual sequel of blunt chest trauma.
In the October 2005 Earthquake in mountainous Azad Kashmir and adjacent areas in Pakistan, a young female sustained crush injury chest and upper abdomen. She remained hospitalized with lower chest pain. All initial investigations were normal and she was discharged symptom-free on conservative management. Six months later, she developed acute left sided chest pain and dyspnoea. Provisional diagnosis of empyema was made on X-ray, and tube thoracostomy was done. Diagnostic VATS revealed gastropleural fistula secondary to necrosis of herniated stomach. Resection of necrosed stomach, repair of diaphragm and decortication and transthoracic repair with lower thoracoplasty two months later was performed but both were unsuccessful. After another 02 months, a Roux-en-Y gastrojejunostomy at fistula site was fashioned which proved curative.
Muzaffar
Muhammad Sultan
MS
Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi. muzaffarsultan@hotmail.com
Umair
Bilal
B
Asghar
Asif
A
Ali
Mujahid Zulfiqar
MZ
Hanif
Muhammad Shoaib
MS
Kamal
Daud
D
D055866:Earthquakes; D005260:Female; D015390:Gastric Bypass; D005747:Gastric Fistula / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010995:Pleural Diseases / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications; D016156:Respiratory Tract Fistula / Q000209:etiology* / Q000601:surgery; D013898:Thoracic Injuries / Q000150:complications*; D020775:Thoracic Surgery, Video-Assisted; D013905:Thoracoplasty; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000150:complications*; D055815:Young Adult