Non-traumatic Gastrothorax: A Potential Mimicker of Tension Pneumothorax

Jonathan D. Pierce, Neal R. Shah, Ata A. Rahnemai-Azar, Amit Gupta


Tension gastrothorax is a rare life-threatening clinical condition caused by intrathoracic herniation of the stomach through a diaphragmatic defect which becomes increasingly distended overtime. If not recognized promptly, this can rapidly progress to respiratory distress, mediastinal shift, and hemodynamic compromise. Initial clinical presentation and imaging findings closely mirror those of tension pneumothorax, confounding diagnosis and potentially leading to unnecessary interventions with increased risk of morbidity and mortality. Here we present a case of an elderly female who presented with a non-traumatic tension gastrothorax and a review of key imaging features and strategies to aid in recognition and accurate diagnosis of this emergent clinical entity.


Gastrothorax; Thoracic imaging; Emergency Radiology; Tension Pneumothorax; Diaphragmatic hernia; Lung ultrasound; X-ray; CT

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