ABSTRACT
Tension gastrothorax develops when the stomach, herniates through a congenital diaphragmatic defect into the thorax and is massively distended by trapped air. We report a case of tension gastrothorax and review the literature. A previously healthy 8 months old female, presented with severe respiratory distress, misdiagnosed as tension pneumothorax. Intercostal tube was inserted. The tube was noted to drain food as well as air. The patient was investigated by radio-contrast swallow, which demonstrated the presence of the stomach in the chest. The patient was operated upon and the stomach, transverse colon and spleen were reduced back to the abdomen. The defects in the stomach and diaphragm were closed. Tension gastrothorax is a life-threatening condition leading to acute and severe respiratory distress. The presence of air filled structure in left hemithorax in a previously healthy child presenting with acute respiratory distress should prompt the inclusion of tension gastrothorax in the differential diagnosis