Respiratory distress during endoscopy--report of an unusual case

Acute respiratory failure secondary to dilatation of herniated stomach

We report the case of a patient who presented acute respiratory failure (ARF) due to gastric distension secondary to hiatus hernia. This clinical condition may have been induced by an interaction between fluphenazine and ipratropium bromide. This exceptional diagnosis needs to be considered when discussing compressive pneumothorax.

Acute gastric dilatation causing respiratory failure and "tension pneumothorax" in an elderly women with a diaphragmatic hernia

The occurrence of respiratory failure as a result of a large diaphragmatic hernia is a well-described entity in infants with congenital hernias. On reviewing the literature, the authors did not find a similar clinical 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 compromise due to recurrent gastric dilatation. Decompression with nasogastric suction resulted in dramatic and immediate relief of the respiratory distress. One should keep in mind the possibility of intrathoracic gastric dilatation as a cause of acute respiratory insufficiency in patients with hiatal hernia.