Tension Gastrothorax in a Child With Undiagnosed Congenital Diaphragmatic Hernia: A Case Report and Proposed Emergency Management Algorithm

Background

Tension gastrothorax is a rare but life-threatening pediatric emergency that most commonly results from herniation of the stomach through an unrecognized congenital diaphragmatic defect, followed by progressive intrathoracic gastric distension and compression of intrathoracic structures. Because its clinical presentation often mimics tension pneumothorax, delayed diagnosis, or inappropriate management may rapidly lead to obstructive shock, respiratory failure, and cardiac arrest. Prompt recognition and timely intervention are therefore essential to prevent fatal outcomes.