PMC10183174_01
(A) Nonobstructive bowel gas pattern with minimal to absent air in the bowel loops. Haziness in left lung base due to left effusion with possible left basilar atelectasis. (B) Diffuse opacification of the left hemithorax with a large curvilinear lucency within the left hemithorax which were concerning for possible left diaphragmatic hernia.
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Due to persistent nausea and vomiting, an abdominal X-ray (AXR) was performed showing a non-obstructive bowel gas pattern with haziness in the left lung base (Figure 1A).  CXR demonstrated diffuse opacification of the left hemithorax suspicious for a left-sided DH (Figure 1B). CT scan confirmed the presence of a large left-sided DH with pleural effusion (Figure 2). 
(A) Coronal and (B) Sagittal view of chest CT scan with and without intravenous contrast remarkable for a left diaphragmatic hernia with herniation of intra-abdominal contents. Additional findings of a possibly dilated stomach with an air-fluid level, large left pleural effusion, and a significant rightward shift of mediastinal structures.
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CXR demonstrated diffuse opacification of the left hemithorax suspicious for a left-sided DH (Figure 1B). CT scan confirmed the presence of a large left-sided DH with pleural effusion (Figure 2). 