ACUTE GASTRIC DILATATION CAUSING RESPIRATORY-FAILURE AND TENSION PNEUMOTHORAX IN AN ELDERLY WOMAN WITH A DIAPHRAGMATIC-HERNIA

The occurrence of respiratory failure as a result of a large diaphragm atic hernia is a well-described entity in infants with congenital hern ias. On reviewing the literature, the authors did not find a smiliar c linical presentation in the adult population. They report the case of an elderly patient with a large hiatus hernia who developed recurrent episodes of life-threatening respiratory failure and hemodynamic compr omise due to recurrent gastric dilatation. Decompression with nasogast ric suction resulted in dramatic and immediate relief of the respirato ry distress. One should keep in mind the possibility of intrathoracic gastric dilatation as a cause of acute respiratory insufficiency in pa tients with hiatal hernia.