title: Tension gastrothorax: acute life-threatening manifestation of late onset congenital diaphragmatic hernia (CDH) in children.
abstract: Tension gastrothorax in children is a life-threatening condition and presents dramatically with acute and severe respiratory distress. It develops when an intra-thoracic stomach herniated through a diaphragmatic defect is massively distended by trapped air and/or fluid causing mediastinal displacement. Tension gastrothorax is often misinterpreted as tension pneumothorax and managed as such leading to increased morbidity and mortality. We present a child with tension gastrothorax and a literature review of this phenomenon.Immediate clinical and radiographic evaluation should lead to accurate diagnosis followed by emergency decompression of the stomach before laparotomy with reduction of herniated viscera and repair of the diaphragmatic defect.
authors.affiliation: Department of Traumatology, Oslo University Hospital Ulleval, Nydalen postbox 4956, N-0424, Oslo, Norway. paanae@ous-hf.no.|Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital Ulleval, Nydalen, Norway. paanae@ous-hf.no.
authors.forename: Pål Aksel
authors.initials: PA
authors.lastname: Næss
authors.affiliation: Department of Traumatology, Oslo University Hospital Ulleval, Nydalen postbox 4956, N-0424, Oslo, Norway.|Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital Ulleval, Nydalen, Norway.
authors.forename: Joachim
authors.initials: J
authors.lastname: Wiborg
authors.affiliation: Department of Traumatology, Oslo University Hospital Ulleval, Nydalen postbox 4956, N-0424, Oslo, Norway.|Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital Ulleval, Nydalen, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Kjellevold
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital Ulleval, Nydalen, Norway.
authors.forename: Christine
authors.initials: C
authors.lastname: Gaarder
mesh_terms: D002648:Child; D019299:Decompression, Surgical / Q000379:methods*; D004630:Emergencies; D065630:Hernias, Diaphragmatic, Congenital / Q000150:complications*; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D011030:Pneumothorax / Q000209:etiology* / Q000601:surgery