Fatal Tension Gastrothorax: Two Case Reports

Area of Science:

• Pathology
• Radiology
• Forensic Medicine

Background:

• Tension gastrothorax is a rare, life-threatening complication of diaphragmatic hernia.
• It involves intrathoracic stomach dilation compressing cardiorespiratory structures.
• Existing literature primarily focuses on emergency department clinical presentations.

Purpose of the Study:

• To report the first adult autopsy cases of tension gastrothorax.
• To discuss the etiology and diagnostic challenges of tension gastrothorax at autopsy.
• To highlight the role of postmortem CT in diagnosing this condition.

Main Methods:

• Presentation of two adult autopsy cases with suspected tension gastrothorax.
• Review of literature on tension gastrothorax and diaphragmatic hernias.
• Analysis of diagnostic utility of postmortem computed tomography (CT).

Main Results:

• Two adult autopsy cases identified where tension gastrothorax was the presumed cause of death.
• Confirmed rarity of autopsy-reported adult cases.
• Demonstrated the diagnostic value of postmortem CT in one case.

Conclusions:

• Tension gastrothorax is a critical, under-recognized autopsy finding.
• Accurate diagnosis at autopsy can be challenging.
• Postmortem CT imaging can significantly aid in identifying tension gastrothorax.