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Management of tension gastrothorax: experience from sub-Saharan Africa
  1. Chidiebere Peter Echieh1,2,
  2. Chimaobi I Nwagboso2,
  3. Stephen Omirigbe Ogbudu2 and
  4. Josiah M Njem3
  1. 1Department of Surgery, University of Calabar, Calabar, Cross River, Nigeria
  2. 2Department of Surgery, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
  3. 3Department of Surgery, University of Jos, Jos, Plateau State, Nigeria
  1. Correspondence to Dr Chidiebere Peter Echieh; cechieh{at}unical.edu.ng

Abstract

Tension gastrothorax is a form of obstructive shock resulting from increased intrathoracic pressure due to a distended herniated stomach. The clinical features of tension gastrothorax are similar to the clinical features of the more common tension pneumothorax. Clinical recognition of this trauma has remained difficult especially in the tropics where most responders are not specialists. We managed a 31-year-old male who, in addition to typical features of obstructive shock secondary to increased intrathoracic pressures, had a recent meal prior to the trauma and a scaphoid abdomen at presentation. We argue that a history of a recent meal before trauma and an unusually scaphoid abdomen could be suggestive of tension gastrothorax and may help to differentiate it from tension pneumothorax. We recommend improved emergency preparedness to help recognise and treat this pathology.

  • cardiothoracic surgery
  • general surgery
  • radiology
  • trauma

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Footnotes

  • Twitter @echiehcp

  • Contributors CPE was the lead surgeon, prepared the manuscript and approved the final version. CIN was involved in the management of the patient, reviewed the manuscript and approved the final version. SOO was involved in the management of the patient, reviewed the manuscript and approved the final version. JMN reviewed the manuscript and approved the final version.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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