case_images: PMC7750025_01
case_images: Chest radiograph showing (A) excessive gastrointestinal gas in the mediastinum or the left side of the chest cavity. A marked right-sided displacement of the mediastinal shadow is observed. In addition, a marked right-sided displacement of the trachea can be seen. (B) The expanded stomach was decompressed by the insertion of a nasogastric (NG) tube, which led to the reversal of the mediastinal displacement.
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case_images: ams2615-fig-0001
case_images: Coma Scale score of 12 (E4V3M5), blood pressure of 98/71 mmHg, pulse of 119/min, temperature of 36.5 C, tachypnea (>=30 times/min), and 85% oxygen saturation (on room air), with diminished breath sounds on the left side. Chest X-ray revealed a large gastric bubble in the left chest cavity, with the mediastinum strongly displaced to the right side (Fig. 1A). Chest X-ray performed after the gastric tube insertion revealed normal mediastinal structures and the absence of the previously present giant gastric bubble in the mediastinum (Fig. 1B).
case_images: Chest and abdominal computed tomography scans (plain films) showing a significantly dilated stomach incarcerated within the mediastinum. A marked displacement of the heart and the left lung can be observed. Craniocaudal inversion of the incarcerated stomach, leading to an "upside-down stomach," can also be visualized. IVC, inferior vena cava.
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case_images: ams2615-fig-0002
case_images: There was no evidence of pneumonia (Fig. 2).
case_images: Chest radiograph on the second day of hospitalization reveals no stomach dilation within the mediastinum or mediastinal displacement; however, extensive infiltrative shadows are seen in both lung fields, suggesting severe pneumonia.
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case_images: PMC7750025_01_AMS2-7-e615-g003.jpg
case_images: ams2615-fig-0003
case_images: Subsequently, the correction of dehydration by infusion stabilized both the blood pressure and tachycardia; however, because she developed aspiration pneumonia, her respiratory status did not improve and she died on the fourth hospital day (Fig. 3).