Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
Abstract
Massive gastric tube dilatation causing cardiomediastinal tamponade is
an unusual cause of obstructive shock after transthoracic
oesophagectomy. A 55-year-old female was operated for total
transthoracic oesophagectomy. Twelve hours after the surgery, she
developed hypotension and raised central venous pressure unresponsive
to fluid infusion and ionotropes. X-ray chest showed a massively
dilated stomach, which was causing intrathoracic tamponade. Suction
applied to the nasogastric tube led to aspiration of 150-200 ml of
fluid and a large volume of air, which led to resolution of the
haemodynamic instability. A simple manoeuvre like nasogastric suction
in postoperative case of oesophagectomy can serve as a diagnostic as
well as therapeutic tool. It must be performed before resorting to
invasive and expensive examination or intervention