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  • Title: Management of acute gastrothorax with respiratory distress: insertion of nasogastric tube as a life saving procedure.
    Author: Azagury DE, Karenovics W, Stähli DM, Mathis J, Schneider R.
    Journal: Eur J Emerg Med; 2008 Dec; 15(6):357-8. PubMed ID: 19078843.
    Abstract:
    An 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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