Turk J Emerg Med
. 2024 Oct 1;24(4):252-254.
doi: 10.4103/tjem.tjem_251_23. eCollection 2024 Oct-Dec. https://pubmed.ncbi.nlm.nih.gov/39564437/
Diagnostic confusion caused by tension gastrothorax – Case series
Mehmet Emin Boleken 1, Tansel Günendi 1, Mehmet Çakmak 1, Veysel Kaya 2, Osman Hakan Kocaman 1
Affiliations Expand
- PMID: 39564437
- PMCID: PMC11573175
- DOI: 10.4103/tjem.tjem_251_23
Abstract
The presence of the stomach in the thorax is called gastrothorax. If excessive dilatation occurs due to a valve mechanism in the stomach which then is herniated into the thorax, it is called tension gastrothorax and the situation can be life-threatening. In late presentation, congenital diaphragmatic hernias or traumatic diaphragmatic hernias, if the stomach located in the thorax is severely distended, it can be confused with tension pneumothorax or pleural effusion/empyema. We presented tension gastrothorax in two patients with distended stomach in the thorax, in which tension pneumothorax and pleural effusion/empyema-like images were created, based on plain X-rays taken at the first admission in the emergency department, which may cause diagnostic confusion. The tension gastrothorax can cause mediastinal shift, which can lead to respiratory distress and eventually cardiac arrest secondary to obstructive shock. In case of mediastinal shift, it should reduce the tension of the stomach located in the thorax by inserting a nasogastric catheter, and if this fails, by aspiration with a needle.
Keywords: Congenital diaphragmatic hernias; emergency interventions; respiratory distress; tension gastrothorax; traumatic diaphragmatic hernias.
Copyright: © 2024 Turkish Journal of Emergency Medicine.
