Tension gastrothorax is a rare and potentially fatal complication of a diaphragmatic hernia, in which a massively dilated, intrathoracic stomach compresses the lungs and mediastinum, causing cardiorespiratory compromise, in a mechanism akin to tension pneumothorax. Although it is very rare, tension gastrothorax has been reported in the literature; however, such reports are almost exclusively restricted to its clinical presentation and treatment in emergency departments. To the best of our knowledge, no adult autopsy case reports of tension gastrothorax have been reported in the literature. We present 2 adult autopsy case reports in which we believe the cause of death was tension gastrothorax, followed by a discussion of what a tension gastrothorax is and its potential etiology, and finally, we discuss the difficulties of making the diagnosis at autopsy, including how postmortem computed tomography imaging can be hugely beneficial as it was in one of our cases.

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http://dx.doi.org/10.1097/PAF.0000000000001003DOI Listing

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Tension gastrothorax is a rare and potentially fatal complication of a diaphragmatic hernia, in which a massively dilated, intrathoracic stomach compresses the lungs and mediastinum, causing cardiorespiratory compromise, in a mechanism akin to tension pneumothorax. Although it is very rare, tension gastrothorax has been reported in the literature; however, such reports are almost exclusively restricted to its clinical presentation and treatment in emergency departments. To the best of our knowledge, no adult autopsy case reports of tension gastrothorax have been reported in the literature.

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Article Synopsis
  • * Tension gastrothorax can mimic other serious conditions like tension pneumothorax or pleural effusion, making it challenging to diagnose correctly based on initial X-rays.
  • * Treatment involves reducing the pressure from the stomach by inserting a nasogastric catheter or, if that fails, using needle aspiration to prevent mediastinal shift, which can cause respiratory distress and cardiac complications.
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The need to suspect tension gastrothorax as a cause of obstructive shock in trauma care: A case report.

Int J Surg Case Rep

May 2024

Department of Emergency and Critical Care Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan. Electronic address:

Introduction: Traumatic tension gastrothorax is a type of obstructive shock similar to tension pneumothorax. However, tension gastrothorax is not well known among emergency physicians, and no consensus has yet been reached on management during initial trauma care. We present a case of traumatic tension gastrothorax in which tube thoracostomy was performed based solely on clinical findings very similar to tension pneumothorax, followed by emergency laparotomy.

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Background: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with abnormal diaphragm development, typically diagnosed prenatally or soon after birth. Late-presenting CDH presents diagnostic challenges due to nonspecific symptoms that can lead to misdiagnoses.

Methods: This report discusses a 35-month-old female initially presenting with predominant gastrointestinal symptoms and minimal respiratory distress.

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