Question 870
{"accessible":true,"alternatives":[{"id":4397,"text":"congenital diaphragmatic hernia"},{"id":4401,"text":"giant bullous emphysema"},{"id":4400,"text":"tension gastrothorax"},{"id":4399,"text":"tension hydropneumothorax"},{"id":4398,"text":"tension pneumothorax"}],"archived":false,"correctAlternativeId":4400,"explanation":"\u003cp\u003e\u003ca href=\"/articles/tension-gastrothorax\"\u003eTension gastrothorax\u003c/a\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003edescribes a rare life-threatening condition caused by mediastinal shift due to a distended stomach herniating into the thorax through a diaphragmatic defect. It can occur due to congenital (younger demographic) or acquired (older demographic)\u0026nbsp;left-sided diaphragmatic defects.\u0026nbsp;Chest radiographs classically demonstrate a large air-filled lucent structure in the left hemithorax causing contralateral mediastinal shift. In differentiating it from a\u0026nbsp;\u003ca href=\"https://radiopaedia.org/articles/tension-pneumothorax\"\u003etension pneumothorax\u003c/a\u003e, the main clinical and radiographic differential diagnosis, the following are useful:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003e\u003cp\u003ethe left hemidiaphragm is poorly defined\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003ethere may be a fluid level in the left hemithorax\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003elack of a gastric bubble\u003c/p\u003e\u003c/li\u003e\n\u003c/ul\u003e","id":870,"imageUrl":"https://prod-images-static.radiopaedia.org/images/28026109/0b959b2906dbdc905e71bb1e5dfb59_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":50945},"imageAttributionCaseInfo":{"title":"Tension gastrothorax","contributor_name":"Jayanth Keshavamurthy","contributor_param":"jayanthmurthy","case_rid":50945,"case_param":"tension-gastrothorax"},"firstQuestionPath":"/questions/870","nextQuestionPath":null,"relatedArticles":[{"id":17362,"title":"Hydropneumothorax","link":"/articles/hydropneumothorax?lang=us"},{"id":15362,"title":"Tension pneumothorax","link":"/articles/tension-pneumothorax?lang=us"},{"id":4996,"title":"Unilateral hypertransradiant hemithorax","link":"/articles/unilateral-hypertransradiant-hemithorax?lang=us"},{"id":54924,"title":"Tension gastrothorax","link":"/articles/tension-gastrothorax?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 65-year-old man presents with acute respiratory distress. What is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/870"}],"attemptsPercentages":[{"alternativeId":"4398","percentage":27},{"alternativeId":"4400","percentage":28},{"alternativeId":"4401","percentage":13},{"alternativeId":"4399","percentage":26},{"alternativeId":"4397","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"congenital-diaphragmatic-hernia"}