Life-Saving Diagnosis: Tension Gastrothorax After Trauma in a Dog

Tension Gastrothorax in a Dog Following Blunt Trauma

Micela Zarelli, DVM; Juana D. Carrillo, DVM; Marta Soler, DVM, PhD; Eliseo Belda, DVM, PhD; Amalia Agut, DVM, PhD

Background:
Tension gastrothorax is a rare but life-threatening condition characterized by herniation of the stomach through a diaphragmatic defect into the thoracic cavity, leading to massive gastric distension and compromised venous return. It can mimic tension pneumothorax clinically, making radiographic evaluation critical for differentiation. The condition often follows trauma and can rapidly deteriorate without prompt intervention.

Methods:
A 4-year-old female mixed-breed dog with a history of being hit by a car two months prior was evaluated for acute respiratory distress, anorexia, vomiting, and exercise intolerance. Physical examination revealed tachycardia, tachypnea, and dull lung sounds over the left hemithorax with tympanic resonance. Hematology showed leukocytosis with neutrophilia; biochemistry was unremarkable. Thoracic radiographs (right lateral and ventrodorsal views) were taken to aid diagnosis.

Results:
Radiographs revealed a large, gas-filled structure occupying the left hemithorax, causing severe mediastinal shift to the right and obliteration of the left diaphragmatic outline—findings consistent with tension gastrothorax. Gastric decompression via orogastric tube resolved respiratory distress. Post-decompression radiographs showed small intestinal loops within the thorax. Surgical diaphragmatic hernia repair was performed within 24 hours, and the patient was discharged two days postoperatively.

Limitations:
This report is based on a single clinical case, limiting generalizability. The diagnosis was primarily based on radiography without mention of confirmatory imaging such as contrast studies before decompression. Long-term follow-up outcomes were not reported.

Conclusions:
This case highlights the importance of distinguishing tension gastrothorax from tension pneumothorax, as both present with severe respiratory compromise but require different management approaches. Radiographic features—such as obliteration of the diaphragmatic outline and large intrathoracic gas-filled structure—are critical diagnostic clues. Early recognition and rapid intervention can lead to a favorable outcome.

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