Gastric wall necrosis owing to its incarceration through a rupture of the diaphragm into the left thoracic cavity

A 73 year-old female patient was admitted to the 3rd Medical Department of Semmelweis University with a painful haematoma in the left loin and respiratory disorders. Her general condition was getting progressively worse. Chest X-ray demonstrated a left sided hemopneumothorax caused by a fractured rib. Thoracic drainage was planned, but the tube introduced on the usual place into the left thoracic cavity perforated the stomach which was incarcerated in the chest. After this an urgent operation was carried out. We found an incarcerated, twisted stomach prolapsing through a rupture of the diaphragm. It was partially necrotic. Excision of the stomach wall with suturing the diaphragm, lavage and drainage of the thoracic and abdominal cavity was carried out. Despite the operation multi-organ failure developed as a result of sepsis, and the patient'died. We discuss the literature in connection with the presentation of this rare and interesting case. In the past 15 years we could not find similar case in the Hungarian surgical literature.