A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.
- emergency medicine
- adult intensive care
- stomach and duodenum
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Contributors PR initially managed the patient. SAK and RKMV identified the tension gastrothorax. PPS did the interpretation of the Computed tomography scan and radiological diagnosis. RKMV and PR did the literature search. PPS contributed the ultrasonography and CT images. SAK wrote the article and he is the guarantor. RKMV, PR, SAK and PPS revised the draft paper.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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