Research: Tension gastrothorax in late diagnosis of congenital diaphragmatic hernia

Radiol Case Rep

. 2025 Sep 24;20(12):6203-6206.

 doi: 10.1016/j.radcr.2025.08.094. eCollection 2025 Dec. https://pubmed.ncbi.nlm.nih.gov/41070290/

Tension gastrothorax in late diagnosis of congenital diaphragmatic hernia

Yasmine Houas 1 2Hela Oueslati 1 2Nada Sghairoun 1 2Asma Guitouni 1 2Riadh Jouini 1 2

Affiliations Expand

Abstract

Tension gastrothorax is a rare but potentially fatal complication of congenital diaphragmatic hernia, frequently mistaken for tension pneumothorax. Early recognition is essential to avoid delays in definitive management. We describe the case of a 14-month-old boy who presented with sudden respiratory distress and non-productive vomiting. Imaging revealed a tension gastrothorax caused by herniation of the stomach, spleen, and colon through a diaphragmatic defect. The patient underwent emergency surgery with successful reduction of the herniated organs and repair of the defect. This case highlights the importance of considering tension gastrothorax in the differential diagnosis of acute pediatric respiratory distress with mediastinal shift. CT imaging plays a crucial role in accurate diagnosis, and timely surgical intervention is lifesaving.

Keywords: CT scan; Case report; Diaphragmatic hernia; Tension gastrothorax.

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