| Difficult diagnosis in the emergency department: hyperemesis in early trimester pregnancy because of incarcerated maternal diaphragmatic hernia. | |
| | |
MedLine Citation:
|
PMID: 18973643 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Hyperemesis gravidarum is a frequent presentation to the ED, which usually resolves with fluid rehydration and antiemetics. Early incarcerated maternal diaphragmatic hernia might be misdiagnosed as relatively benign hyperemesis gravidarum in the first two trimesters of pregnancy. Diagnosis is missed because of non-specific presentation with abdominal pain, nausea and vomiting. Hernias rarely become symptomatic even in latter stages of pregnancy, as the uterus increases in size with each trimester and with raised intra-abdominal pressure from uterine contraction during labour. Symptoms progress with incarceration and strangulation of abdominal contents within the thoracic cavity, compression of the lung and disruption of caval venous return. A woman at 19-week gestation presented with delayed diagnosis of strangulated diaphragmatic hernia, representing the earliest gestation in the published literature when this has occurred. She had repeatedly been misdiagnosed with hyperemesis gravidarum. It is worthwhile considering incarcerated maternal diaphragmatic hernia as an unusual cause of refractory vomiting in pregnancy, when associated with clinically significant upper abdominal pain and progressive respiratory embarrassment. This might occur as early as the mid-second trimester, and without uterine contraction. |
| | |
Authors:
|
Joseph Yuk Sang Ting |
Related Documents
:
|
18626563 - Absorption of semiconductor nanocrystals by the aquatic invertebrate ceriodaphnia dubia. 7001013 - Ultrasonically guided transabdominal encephalocentesis. 18803903 - Postpartum cortical blindness. |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Emergency medicine Australasia : EMA Volume: 20 ISSN: 1742-6723 ISO Abbreviation: Emerg Med Australas Publication Date: 2008 Oct |
Date Detail:
|
Created Date: 2008-10-31 Completed Date: 2009-03-11 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101199824 Medline TA: Emerg Med Australas Country: Australia |
Other Details:
|
Languages: eng Pagination: 441-3 Citation Subset: IM |
Affiliation:
|
Department of Emergency Medicine, Mater Public Hospitals, South Brisbane, Queensland, Australia. joseph.ting@mater.org.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Emergency Service, Hospital / statistics & numerical data* Female Gastrectomy Hernia, Diaphragmatic / complications, diagnosis*, surgery Humans Hyperemesis Gravidarum / diagnosis*, etiology, surgery Maternal Welfare* Pregnancy Pregnancy Trimester, Second* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Cardiac arrhythmia during propofol sedation.
Next Document: Hyperglycemia may alter cytokine production and phagocytosis by means other than hyperosmotic stress...