IJAR.2021.183
Type of Article: Case Report
Volume 9; Issue 4 (December 2021)
Page No.: 8185-8188
DOI: https://dx.doi.org/10.16965/ijar.2021.183
An Isolated Dextrogastria Simulating Diaphragmatic Rupture in a Post-Traumatic Context
L. G. Akpo 1, N. B. Mar *2, N. Badji 1, S. Barry 1, H. Deme 1, M. H. Toure 1, A. D. Diop 3, S. B. Diop 3, E. H. Niang 1, As. Ndiaye 4.
*1 Service de Radiologie et d’Imagerie Médicale CHU Aristide Le Dantec, Dakar Sénégal
2 Anatomy laboratory, Iba Der THIAM University of Thiès, Sénégal.
3 Service de Radiologie et d’Imagerie Médicale CHU FANN, Dakar.
4 Anatomy laboratory, Assane Seck University of Ziguinchor, Sénégal.
Corresponding Author: Dr. Ndeye Bigue MAR, Anatomy laboratory, Iba Der THIAM University of Thiès, Sénégal. E-Mail: biguemarmbaye@yahoo.fr
ABSTRACT
We report a case of isolated dextrogastria discovered in imaging a 34-years-old woman who was in the emergency department for vomiting and fluctuating right chest pain following a road accident. It was a collusion between 2 motorcycles, the patient being a rear passenger, performing a whiplash mechanism with a brief initial loss of consciousness. The day after the accident, she complained of left cervical swelling, painful with dysphagia to solids. Physical examination revealed bilateral palpebral oedema. There was a decrease in right vesicular murmurs with symmetrical tympanism towards the base of the lung. The rest of the examination was normal. The chest x-ray showed digestive loops above the liver that appeared to be located in the right intra-thoracic, suggesting in this context a diaphragmatic rupture. The OGDT and the thoraco-abdominal CT made possible to correct the diagnosis of type II dextrogastria by showing the stomach and part of the colon located on the right, above the liver, under the diaphragmatic dome which is disembowelled, pushing back the lung homolateral up. There was also a deviation of the ipsilateral thoracic esophagus in continuity with the stomach. The liver, in the right quasi-lateral position, is forced downward, extending to the lower edge of the ipsilateral flank. The other viscera kept their usual topographies.
KEY WORDS: Dextrogastria, Isolated dextrogastria, Chest pain, Dysphagia.
REFERENCES
[1]. Nagdeve NG, Sarin YK. Volvulus complicating dextrogastria in an infant. Indian Pediatr 2007;44:142–4.
[2]. C Shwaartz, E Duggan, DS Lee, CM Divino, EH Chin. Diaphragmatic eventration presenting as a recurrent diaphragmatic hernia. Ann R Coll Surg Engl 2017; 99: e196–e199.
[3]. Man Mohan Harjai,Inna Kedle Indrajit1 and Monal Kansra. Isolated Dextrogastria Simulating Congenital Diaphragmatic Hernia: A Diagnostic Dilemma. Asian Joural of surgery 2010;33(1).
[4]. J. George Teplick, Robert J. Wallner, Arnold H. Levine, Marvin E. Haskin and Steven K. Teplick. Isolated Dextrogastria: Report of Two Cases. AJR 1979;132:124-126.
[5]. Pallavi Aga, Umesh C. Parashari, Anit Parihar, Ragini Singh, Neera Kohli. MRI in isolated dextrogastria with eventration of the right hemidiaphragm with associated mesentero-axial volvulus. Pediatr Radiol 2010;40:1576–1578.
[6]. P. M. Hewlett. Isolated dextrogastria. British Journal of Radiology, 1982;55:681-68.
[7]. Dott NM: Anomalies of intestinal rotation. BrJ Surg. 1923;11:251-286.
[8]. S. M. Cedrick, K. F. Maruis, K. Z. Mireille, M. S. Nelly, M. P. Patience, M. Shem et al. Syndrome de Chilaiditi chez un nouveau-né, à propos d’un cas. Pan African Medical Journal. 2014;19:239.
