[Laparoscopic @entity356 in XXXX secondary to diaphragmatic eventration in an adult @entity1 ].

@entity1 @entity548 @entity1819 @entity1661 @entity344 @entity11034 @entity19138 @entity158 @entity356
BACKGROUND: Acute @entity11034 is a rare, but potentially life-threatening, cause of upper @entity344 . CLINICAL CASE: Male of 60  years old with severe @entity158 and @entity1661 with haematemesis on two occasions. The @entity1 was haemodynamically stable, with @entity1661 and palpable @entity19138 . Hematic cytology showed: haemoglobin 8.2g/dl and haematocrit 27%. Abdominal X-ray showed an elevation of left diaphragm with a hugely dilated @entity1819 . A nasogastric tube was inserted. Endoscopy was performed. There was no active @entity548 , but it was impossible to reach the duodenum due to the @entity1819 distortion. The upper gastrointestinal X-ray study showed the appearance of an inverted @entity1819 in the chest and an organoaxial gastric torsion. The CT scans of thorax and abdomen showed a gastric ascent into the thoracic cavity. Laparoscopic surgery was performed, finding the left hemi-diaphragm elevated, and the @entity1819 , splenic angle of the colon, the spleen and tail of the pancreas were also raised. A linear gastrectomy ( @entity356 ) was performed. The postoperative progress was satisfactory. Oral feeding was started 72hours after surgery, and the @entity1 was discharged, and has remained asymptomatic during the following by 8  years. CONCLUSIONS: Emergency physicians must maintain a high level of suspicion in @entity1 that present with signs and symptoms suggesting upper digestive tract occlusion. The @entity356 is an excellent alternative to avoid recurrence of @entity11034 .
