Search
Tension gastrothorax?
- Tension gastrothorax is a life threatening condition characterized by herniation of the stomach through a defect in the diaphragm with compression of the mediastinal contents
- Although many cases occur in pediatric patients (secondary to congenital defects), adults with a history of diaphragmatic injury are at risk (also patients with a type III or IV hiatal hernia)
- The clinical presentation is the same as a tension pneumothorax - hypotension, tachycardia, hypoxia, JVD, and decreased breath sounds
- CXR appearance can be very similar to tension pneumothorax, however, the treatment is substantially different
- Needle decompression and tube thoracostomy are contraindicated, as this may cause visceral perforation
- The treatment of choice is NGT (or OGT) decompression followed by surgical repair
References
Patton J, Gonzales J, Dillard TA, Szerlip HM. Chest 2008;134:872-5.