{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T09:27:59Z","timestamp":1778232479952,"version":"3.51.4"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"vor","delay-in-days":302,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The incidence of Bochdalek hernias in adults is much more than previously reported. Though most of these are asymptomatic. Tension gastrothorax is a rare complication of these. Literature about the endoscopic management of a tension gastrothorax is extremely sparse. In this case report, we describe how we combined laparoscopy and thoracoscopy in an emergency setting to manage a case of tension gastrothorax with an underlying Bochdalek hernia defect in an adult.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient profile<\/jats:title>\n                    <jats:p>A 27 year old male presented to our emergency with tension gastrothorax and a gastric volvulus with an underlying Bochdalek hernia defect, exhibiting the classical Borchardt\u2019s triad. The patient underwent an emergency surgery, through a minimally invasive approach wherein the herniated contents were reduced, the gastric volvulus detorted and a repair of the diaphragmatic defect was performed. His post-operative course was uneventful.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Tension gastrothorax, is a diagnostic challenge as an air-fluid level in the thorax on radiology with worsening respiration causes as many as 38% of these cases to be misdiagnosed as tension pneumothorax, hydro-pneumothorax, hemothorax, empyema, effusion or pneumonia. Various techniques of decompression have been described in literature but, employing those, in case of a misdiagnosis may have catastrophic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We strongly recommend employing a combined laparoscopic and thoracoscopic approach for an emergency repair of a tension gastrothorax in a hemodynamically stable patient as, it poses all the advantages of minimal access surgery and is available, at smaller centres, even in an emergency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2019.10.076","type":"journal-article","created":{"date-parts":[[2019,11,3]],"date-time":"2019-11-03T08:41:14Z","timestamp":1572770474000},"page":"141-147","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Combined laparoscopic and thoracoscopic approach for tension gastrothorax in a foramen of Bochdalek hernia"],"prefix":"10.1097","volume":"65","author":[{"given":"Saurabh","family":"Gandhi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Bhandarwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidhisha","family":"Sadhwani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chintan","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amol","family":"Wagh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eham","family":"Arora","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-31-20260114","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/BF02470876","article-title":"Adult Bochdalek hernia\u2014clinical features, management and results of treatment","volume":"21","author":"Thomas","year":"1991","journal-title":"Jpn. J. Surg"},{"key":"R2-31-20260114","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1136\/emj.2002.004697","article-title":"Bochdalek hernia masquerading as a tension pneumothorax","volume":"21","author":"Dalton","year":"2004","journal-title":"Emerg. Med. J"},{"key":"R3-31-20260114","first-page":"1","article-title":"Tension gastrothorax with gastric perforation secondary to Bochdalek Hernia in an adult, case report","volume":"3","author":"Tolentino Gonzalez Christian","year":"2017","journal-title":"Arc J. Surg"},{"key":"R4-31-20260114","doi-asserted-by":"crossref","first-page":"241","DOI":"10.15380\/2277-5706.JCSR.17.10.002","article-title":"Acute tension gastrothorax in an adult","volume":"6","author":"Gowrinath","year":"2017","journal-title":"J. Clin. Sci. Res"},{"key":"R5-31-20260114","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0735-6757(84)90008-1","article-title":"Tension Gastrothorax complicating post-traumatic rupture of the diaphragm","volume":"2","author":"Ordog","year":"1984","journal-title":"Am. J. Emerg. Med"},{"key":"R6-31-20260114","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1016\/j.jpedsurg.2013.05.066","article-title":"Tension gastrothorax in children: introducing a management algorithm","volume":"48","author":"Ng","year":"2013","journal-title":"J. Pediatr. Surg"},{"key":"R7-31-20260114","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1016\/j.jpedsurg.2005.05.079","article-title":"Tension gastrothorax","volume":"40","author":"Horst","year":"2005","journal-title":"J. Pediatr. 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