Fig. 2

Algorithm of initial resuscitation for tension gastrothorax. *It might be necessary to intubate because of conversion from negative intrathoracic pressure to positive pressure to avoid exacerbation. **After successfully resolving the obstructive shock, definitive surgery can be delayed until the patients respiratory, hemodynamic, and coagulation statuses have stabilized. Definition of abbreviations: NGT nasogatric tube, NT needle thoracostomy, TT tube thoracostomy