Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma
Background. Tension gastrothorax is a rare life-threatening condition that occurs when the stomach is herniated into the thoracic cavity, most often through the congenital left posterolateral diaphragmatic defect, causing a mediastinal shift when distended with gas and fluid. Case Presentation. A...
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| Language: | English |
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Hacettepe University Institute of Child Health
2025-05-01
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| Series: | The Turkish Journal of Pediatrics |
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| Online Access: | https://turkjpediatr.org/article/view/5329 |
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| author | Sofija Cvejic Ivana Dasic Nenad Zdujic Sanja Sindjic Antunovic Dejan Nikolic Polina Pavicevic |
| author_facet | Sofija Cvejic Ivana Dasic Nenad Zdujic Sanja Sindjic Antunovic Dejan Nikolic Polina Pavicevic |
| author_sort | Sofija Cvejic |
| collection | DOAJ |
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Background. Tension gastrothorax is a rare life-threatening condition that occurs when the stomach is herniated into the thoracic cavity, most often through the congenital left posterolateral diaphragmatic defect, causing a mediastinal shift when distended with gas and fluid.
Case Presentation. A previously healthy 2-year-old boy was admitted with acute abdominal pain, vomiting and dyspnea. Chest X-ray was initially interpreted as hydropneumothorax, but after careful observation the decision was made to insert a nasogastric tube and to perform a computerized tomography scan to confirm the suspicion of tension gastrothorax. Laparotomy was performed the following day, organs were repositioned into the abdomen and reconstruction of the left hemidiaphragm was conducted.
Conclusion. When symptoms of respiratory distress occur in an otherwise healthy child, tension gastrothorax should be on the list of differential diagnosis. It is important to recognize distinct radiographic features of this life-threatening condition in order to promptly manage it. Initial placement of nasogastric tube for decompression should be followed by the reduction of the organs into the abdomen and diaphragmatic repair.
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| format | Article |
| id | doaj-art-b164625e687c40ab96ea8f9abd4fe6a0 |
| institution | Kabale University |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-b164625e687c40ab96ea8f9abd4fe6a02025-08-20T03:55:22ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212025-05-0167210.24953/turkjpediatr.2025.5329Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemmaSofija Cvejic0https://orcid.org/0000-0002-5416-4559Ivana Dasic1https://orcid.org/0000-0002-5114-6638Nenad Zdujic2https://orcid.org/0009-0001-2610-8891Sanja Sindjic Antunovic3https://orcid.org/0000-0002-9794-9743Dejan Nikolic4https://orcid.org/0000-0002-0609-9916Polina Pavicevic5https://orcid.org/0000-0002-2206-1846Department of Radiology, University Children’s Hospital, Belgrade, SerbiaDepartment of Radiology, University Children’s Hospital, Belgrade, SerbiaDepartment of Surgery, University Children’s Hospital, Belgrade, SerbiaDepartment of Surgery, University Children’s Hospital, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, SerbiaFaculty of Medicine, University of Belgrade, Serbia; Physical Medicine and Rehabilitation Department, University Children’s Hospital, Belgrade, SerbiaDepartment of Radiology, University Children’s Hospital, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Serbia Background. Tension gastrothorax is a rare life-threatening condition that occurs when the stomach is herniated into the thoracic cavity, most often through the congenital left posterolateral diaphragmatic defect, causing a mediastinal shift when distended with gas and fluid. Case Presentation. A previously healthy 2-year-old boy was admitted with acute abdominal pain, vomiting and dyspnea. Chest X-ray was initially interpreted as hydropneumothorax, but after careful observation the decision was made to insert a nasogastric tube and to perform a computerized tomography scan to confirm the suspicion of tension gastrothorax. Laparotomy was performed the following day, organs were repositioned into the abdomen and reconstruction of the left hemidiaphragm was conducted. Conclusion. When symptoms of respiratory distress occur in an otherwise healthy child, tension gastrothorax should be on the list of differential diagnosis. It is important to recognize distinct radiographic features of this life-threatening condition in order to promptly manage it. Initial placement of nasogastric tube for decompression should be followed by the reduction of the organs into the abdomen and diaphragmatic repair. https://turkjpediatr.org/article/view/5329tension gastrothoraxcongenital diaphragmatic herniachildren |
| spellingShingle | Sofija Cvejic Ivana Dasic Nenad Zdujic Sanja Sindjic Antunovic Dejan Nikolic Polina Pavicevic Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma The Turkish Journal of Pediatrics tension gastrothorax congenital diaphragmatic hernia children |
| title | Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma |
| title_full | Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma |
| title_fullStr | Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma |
| title_full_unstemmed | Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma |
| title_short | Tension gastrothorax in late-presenting congenital diaphragmatic hernia: a diagnostic dilemma |
| title_sort | tension gastrothorax in late presenting congenital diaphragmatic hernia a diagnostic dilemma |
| topic | tension gastrothorax congenital diaphragmatic hernia children |
| url | https://turkjpediatr.org/article/view/5329 |
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