• Eur J Emerg Med · Dec 2008

    Case Reports

    Management of acute gastrothorax with respiratory distress: insertion of nasogastric tube as a life saving procedure.

    • Dan E Azagury, Wolfram Karenovics, Dominique M Stähli, Jérôme Mathis, and Rémi Schneider.
    • Surgery Department, Neuchâtelois Hospital, Neuchâtel, Switzerland. dan.azagury@ne.ch
    • Eur J Emerg Med. 2008 Dec 1; 15 (6): 357-8.

    AbstractAn 86-year-old patient was transferred to our institution with acute respiratory distress. A tension pneumothorax was suspected, but needle decompression was unsuccessful. Instead of the suspected pneumothorax, the chest radiograph revealed a large 'tension gastrothorax'. In a matter of seconds, the insertion of a nasogastric tube resulted in drastic improvement of the critical clinical state. Acute tension gastrothorax is a rare, but classic, complication of paraoesophageal hernias. Its clinical presentation can be dramatic and rapidly lethal, immediate action is therefore warranted. Nasograstric tube insertion is a life saving procedure to be undertaken without delay. However, tension gastrothorax is a rare entity. Therefore, if tension pneumothorax is suspected, needle decompression should not be delayed.

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