Diagnostic confusion caused by tension gastrothorax – Case series
Mehmet Emin Boleken1
, Tansel Günendi1, Mehmet Çakmak1, Veysel Kaya2, Osman Hakan Kocaman1
1Department of Pediatric Surgery, Harran University Medical Faculty, Şanlıurfa, Turkey
2Department of Radiology, Harran University Medical Faculty, Şanlıurfa, Turkey
Keywords: Congenital diaphragmatic hernias, emergency interventions, respiratory distress, tension gastrothorax, traumatic diaphragmatic hernias
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.
How to cite this article: Boleken ME, Günendi T, Çakmak M, Kaya V, Kocaman OH. Diagnostic confusion caused by tension gastrothorax – Case series. Turk J Emerg Med 2024;24(4):252-4.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
(1) MEB: Collected patient data, drafted and revised the manuscript,(2) TG, (3) MÇ, (4) VK, (5) OHK: Collected patient data and drafted the manuscript. The corresponding author is responsible for ensuring that the descriptions are accurate and agreed by all authors.
None Declared.
None.