PMC4955483_01
Chest radiography showing right lung opacity with left Mediastinal shift (observation 1) (Up left)
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F1
Further, radiology of the chest showed a dense homogeneous opacity occupying the entire lung field with a displacement of the mediastinum [Figures 1 and 2].
Image after drainage (observation 1) (Up left)
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F2
Further, radiology of the chest showed a dense homogeneous opacity occupying the entire lung field with a displacement of the mediastinum [Figures 1 and 2].
Intrathoracic chest tube in the liver (observation 1) (Up left)
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F3
Surgical exploration revealed some haemoperitoneum, a transverse rupture of the right hemi diaphragm about 10 cm with irregular edges, liver in the chest with fracture of lower pole segment V and a laceration of about 0.5 cm on the upper surface caused by the chest tube drain [Figures 3 and 4].
Right diaphragmatic rupture after reduction of the liver (observation 1) (Up left)
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F4
Surgical exploration revealed some haemoperitoneum, a transverse rupture of the right hemi diaphragm about 10 cm with irregular edges, liver in the chest with fracture of lower pole segment V and a laceration of about 0.5 cm on the upper surface caused by the chest tube drain [Figures 3 and 4].
Control chest radiography on 24 months post-operative (observation 1) (Up left)
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F5
Two years on follow-up, the child remained symptom free with a normal chest radiograph [Figure 5].
PMC4955483_02
Chest radiograph (AP) showing right lung opacity (observation 2) (Up left)
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F6
An antero-posterior chest radiograph showed a fracture the anterior arcs the 6th, 7th, 8th, and 9th left ribs, right lung opacity with right apical pneumothorax [Figure 6].
Image after drainage (observation 2) (Up left)
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F7
The radiograph showed a lack of improvement in radiological images [Figure 7].
Chest computed tomography-scan objectivising an intrahepatic drain (arrow) with the liver in intrathoracic position (observation 2) (Fronf left)
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F8
Based on diagnostic uncertainty, thoraco-abdominal CT scan performed on day 2 of hospitalization showed a liver with intrathoracic drain within it [Figure 8].
diaphragmatic rupture after reduction of liver and visualization of chest tube (observation 2) (Up left)
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F9
At surgery, the liver had herniated into the thoracic cavity through a gap of about 10 cm in diameter in the right hemi diaphragm [Figure 9].
Control post-operative chest X-ray M 16 (observation 2) (Up left)
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F10
Sixteen months later, the child has symptom free with a normal radiograph [Figure 10].