Life threatening nontraumatic tension gastrothorax

Abstract

Key Clinical MessageTension gastrothorax is a rare condition, which poses a diagnostic dilemma and can be mistaken for a tension pneumothorax. Awareness of the risk factors, clinical presentation, and radiology findings of tension gastrothorax can help with the prompt identification and successful management of this life‐threatening condition.

Management of tension gastrothorax: experience from sub-Saharan Africa

“…Management algorithm for the management of tension gastrothorax had been earlier recommended 6. Options for decompression include insertion of wide-bore nasogastic tube,8 needle thoracostomy,5 percutaneous aspiration,7 endoscopic decompression,9 10 emergency laparotomy and emergency thoracotomy 5. While needle thoracostomy is almost always successful in decompressing tension pneumothorax, it is successful in decompressing tension gastrothorax in only 9% of the patients 6.…”

Cardiopulmonary arrest secondary to compression of the heart owing to esophageal hiatal hernia: a case report

“…Interestingly, all reports of tension gastrothorax describe patients in shock or cardiopulmonary arrest who were diagnosed by CT imaging and attempted to decompress with a gastric tube. [8][9][10] Shoji et al 10 authored the eight previously reported cases, and only two cases involved hiatal hernia without trauma. In all of these reports, insertion of a gastric tube was attempted; however, in some cases, the insertion was unsuccessful and return of spontaneous circulation was achieved with volume resuscitation and cardiopulmonary resuscitation.…”

“…Heart failure owing to the esophageal hiatal hernia displacing the heart 6,7 and tension gastrothorax in patients with obstructive shock due to a significant displacement of the heart by an expanded stomach have also been reported. Interestingly, all reports of tension gastrothorax describe patients in shock or cardiopulmonary arrest who were diagnosed by CT imaging and attempted to decompress with a gastric tube 8–10 . Shoji et al 10 .…”