Tension gastrothorax in a Nigerian trauma centre: A rare diagnostic challenge

Abstract

Tension gastrothorax was first reported in the medical literature over 35 years ago when it was found as a complication of traumatic rupture of the diaphragm in an adult. It is known to be a life-threatening condition which can be difficult to diagnose. This study is aimed at re-emphasizing the consideration of this life-threatening condition as a close differential diagnosis of tension pneumothorax in a trauma setting.
We present a 38year old man who developed severe respiratory distress few hours after a road traffic crash and was later found to have tension gastrothorax. He was initially managed with nasogastric tube decompression and then surgical repair of the left diaphragm.
Our patient was a young man in his productive age. His initial presentation and radiograph were somewhat misleading to the medical officer who was the first doctor to review. He was closely monitored in the resuscitation room as per protocol. This facilitated prompt intervention when he dramatically deteriorated.
Emergency room doctors should be reminded to suspect this rare condition in a patient with blunt chest trauma irrespective of initial clinical findings but most importantly as a differential diagnosis of tension pneumothorax