Tuesday October 16, 2007


Q: What is your diagnosis ?

Tuesday October 16, 2007



Q: What is your diagnosis ?



Answer: Tension gastrothorax

Tension Gastrothorax is a frequent complication of trauma with diaphragmatic injury. In the spontaneously ventilating patient the negative pressure generated in the thoracic cavity progressively sucks the stomach into the chest with each breath. Eventually, respiratory and haemodynamic compromise ensue, as with a classic tension pneumothorax.

Its important to differential diagnosis from Tension Pneumothorax.

Immediate treatment is either Nasogastric tubes placement to decompress the stomach - although placement may be difficult due to difficulty in passing the diaphragm, or Positive pressure ventilation to allow immediate re-expansion of the lung which forces intraperitoneal contents back into the abdomen.

As operative repair is the eventual treatment, its better to just intubate patient.