A 66-year-old drunk patient complained Severe pain in the left thoracic and left upper abdomen, radiating to the back. Due to the symptoms described and the known coronary single-vessel disease with the condition after stent implantation, the patient was referred to the emergency doctor at the chest pain unit. Laboratory tests showed non-ST elevation myocardial infarction (troponin I 0.36 ng / mL, creatine kinase 2 553 U / L). Coronary angiography was able to rule out an acute myocardial infarction, although no other pathological pathologies were found. The following day, the patient reported recent fall on the left side of the thorax. Due to the laboratory constellation and detailed anamnesis, this could have been considered primarily. An X-ray and computed tomography of the thorax revealed diaphragmatic hernia of unknown age on the left with pinched thoracic stomach (figure) . Acute rupture of the diaphragm after trauma is reported with frequency of 1–5%. For upside-down stomach and strangulation-related gastric gangrene, the emergency gastrectomy with esophagojejunostomy was performed. The patient left the hospital on the 7th postoperative day.
Dr. med. Dani Id, Dr. med. Phillip Grotherr, Prof. Dr. med. Claus Schmitt, Clinic for Cardiology, Angiology and Intensive Care Medicine, Städtisches Klinikum Karlsruhe, Dani.Id@Klinikum-Karlsruhe.de
Conflict of interest: The authors declare that no There is conflict of interest.
Citation: Id D, Grotherr P, Schmitt C: A fall with consequences..Dtsch Arztebl Int 2018; 115: 275 . DOI: 10.3238 / arztebl.2018.0275
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