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Surgical repair was performed but was delayed by COVID-19. This case provides a rare presentation of an acute life-threatening tension gastrothorax with difficult management considerations. A review of the management options is undertaken.<\/jats:p>","DOI":"10.1136\/bcr-2020-240478","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T12:36:14Z","timestamp":1617885374000},"page":"e240478","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Acute atraumatic peri-arrest tension gastrothorax presenting to the emergency department"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1848-3982","authenticated-orcid":false,"given":"James","family":"Phelan","sequence":"first","affiliation":[{"name":"Accident & Emergency, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rengarajan","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Accident & Emergency, Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, 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