Acute gastric distension: a lesson from the classics

Acute gastrothorax may masquerade as a tension pneumothorax. Once the diagnosis is suspected, a nasogastric tube should be passed to release the gastric distension and confirm the diagnosis (Fein et al, 1993). This article describes a case where, despite having made the correct diagnosis, the authors were unable to pass a nasogastric tube in a child who was rapidly deteriorating.