PERFORATION OF GASTRIC ULCER INTO THE MEDIASTINUM-REPORT OF A CASE-

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  • 胃潰瘍の縦隔内穿孔の1例

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Abstract

A 33-year-old man was admitted to the hospital because of sudden epigastralgia. There was no muscle guarding on admission. Left pleural effusion appeared a day after admission. A computed tomography (CT) of the thorax revealed a perforation of the digestive tract and an abscess of the mediastinum. An emergency thoracotomy was carried out. The diagnosis of perforation of the gastric ulcer in a hiatus hernia into the medi-astinum was made during the operation. The primary suture was performed. On the 34th day after the opera-tion the patient was discharged.<br>It must be noted that the gastric ulcer in a hiatus hernia may perforate into the mediastinum, especially if pleural effusion is confirmed on simple x-ray films of the chest. In that case, early diagnosis with imagings including chest CT and emergency operation to save the patient's life are thought important.

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