© 2004 by BMJ Publishing Group Ltd & British Society of Gastroenterology
EDITOR'S QUIZ: GI SNAPSHOT
An unusual cause of postoperative dyspnoea
1 Department of Trauma and Orthopaedics, York Hospital, York, UK
2 Department of General Surgery, York Hospital, York, UK
Correspondence to:
Correspondence to:
Mr R U Ashford
Rose Cottage, Crooked Lane, Kirk Hammerton, York YO26 8DG, UK; robert.ashford@virgin.net
Keywords: oesophagus; rupture; tension pneumothorax
| The first 150 words of the full text of this article appear below. |
A 79 year old gentleman underwent exploration of a dislocated hip arthroplasty. During surgery, he regurgitated bile stained fluid into his laryngeal mask airway. His chest remained clear, saturation did not fall, and chest radiography immediately postoperatively was unremarkable.
Twelve days postoperatively he developed respiratory distress associated with right sided pleuritic chest pain. Air entry was symmetrical and he was tachypnoeic (respiratory rate 26), hypotensive, and tachycardic (heart rate 140 beats/min). Electrocardiography revealed a right heart strain pattern. Oxygen saturation initially was 80%. Arterial blood gases on initial oxygen therapy and their subsequent improvement are given in table 1
.
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View this table: [in a new window] Table 1 Arterial blood gases on initial oxygen therapy and their subsequent improvement |
At medical review, chest radiography was interpreted as right lower zone shadowing and a preliminary diagnosis of postoperative pulmonary embolus was postulated, treatment with oxygen continued, and low molecular weight heparin was commenced.
An urgent computed tomography (CT) scan
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EDITOR’S QUIZ: GI SNAPSHOT
Gut 2004 53: 1286.[Extract] [Full Text] [PDF]
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