Advertisement

Internal and Emergency Medicine

, Volume 13, Issue 1, pp 133–134 | Cite as

Left hydropneumothorax in a patient with acute epigastric pain: an important clue!

  • Mercè Grau PérezEmail author
  • Juan Mariano Aguilar Mulet
  • Cristina Santiago Poveda
CE - MEDICAL ILLUSTRATION
  • 103 Downloads

A 67-year-old female smoker with osteoporosis on weekly alendronate and occasional constipation, presented to the Emergency Department complaining of abdominal pain. The pain had started 2 h before, when having a loose bowel movement. It was localized to the epigastrium and radiated to the left side of her back. After a single episode of vomiting preceded by forceful retching, the pain suddenly intensified. While in the examination room, she started complaining of dyspnea. On examination, she looked pale, diaphoretic, and tachypneic. Her vital signs were as follows: BP 130/70 mmHg, HR 75 bpm, SO2 93%, T35.4 °C. Lung auscultation revealed decreased breath sounds in the upper left field and bibasilar crackles. The abdominal examination was unremarkable. The ECG did not show any significant abnormalities. Laboratory tests showed leukocytosis of 20.600 with neutrophilia. Liver and kidney function tests, cardiac enzymes, amylase, and electrolytes were within normal limits. Arterial blood...

Notes

Acknowledgements

We thank Fernando Roca, MD, for his help in the writing of this manuscript.

Compliance with ethical standards

Conflict of interest

None.

Statement of human and animal rights

All studies involving Human subjects were compliant with ethical standards set by the local Research Ethics Committee as well as the 1964 declaration of Helsinki and its later amendments. No animal studies were performed.

Informed consent

Informed consent was obtained from the patient.

References

  1. 1.
    Blencowe NS (2013) Spontaneous esophageal rupture. BMJ 346:f3095. doi: 10.1136/bmj.f3095 CrossRefPubMedGoogle Scholar
  2. 2.
    Mackler SA (1952) Spontaneous rupture of the esophagus; an experimental and clinical study. Surg Gynecol Obstet 95(3):354–356Google Scholar
  3. 3.
    Gupta A, Mody P, Bhushan S (2016) An unusual cause of shortness of breath. Intern Emerg Med 11(7):1025–1026. doi: 10.1007/s11739-015-1373-7 CrossRefPubMedGoogle Scholar
  4. 4.
    Han SY, McElvein RB, Aldrete JS, Tishler JM (1985) Perforation of the esophagus: correlation of site and cause with plain film findings. AJR 145:537–540. doi: 10.2214/ajr.145.3.537 CrossRefPubMedGoogle Scholar
  5. 5.
    Kiev J, Amendola M, Bouhaidar DB, Sandhu BSm, Zhao X, Maher J (2007) A management algorithm for esophageal perforation. Am J Surg 194:103–106. doi: 10.1016/j.amjsurg.2006.07.024 CrossRefPubMedGoogle Scholar

Copyright information

© SIMI 2017

Authors and Affiliations

  1. 1.Emergency DepartmentHospital Universitario de La PrincesaMadridSpain
  2. 2.Dermatology DepartmentHospital Universitario de Gran Canaria Doctor NegrínLas Palmas de Gran CanariaSpain

Personalised recommendations