CTICasesTraumatic Gastric Herniation and Rupture into the Pericardium
Imaging findings
A young man ejected from a motor vehicle collision has a chest radiograph showing an apparent gastric fundus projecting into the chest with preserved visualization of the lower lobe vessels and heart border. CT shows the stomach herniated not only into the thorax but directly through a tear in the pericardium, with gas and gastric fundus abutting and exerting mass effect on the right ventricle.
Key takeaways
Traumatic gastric herniation can rarely rupture directly into the pericardial space through a traumatic pericardial tear, producing mass effect on the heart itself -- a more dramatic and unusual variant of traumatic diaphragmatic hernia that should be considered when herniated stomach appears to abut or indent the cardiac chambers rather than remaining confined to the pleural space.
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