PMC9852327_01
Chest radiographs. (A) Initial chest radiograph revealing an elevated left hemidiaphragm and pneumothorax in the left lung. (B) Chest radiograph showed left pleural effusion and a mediastinal shift toward the right with an elevated left hemidiaphragm. (C) Postoperative chest radiograph revealed normal positions of the stomach bubble and diaphragmatic contour.
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F1
Chest radiography revealed a pneumothorax in the left lung with an elevated left hemidiaphragm (Figure 1A). Chest x-ray revealed a left pleural effusion and a mediastinal shift toward the right with an elevated left hemidiaphragm (Figure 1B). The postoperative chest x-rays were normal, and the patient was discharged in good condition 10 days after the second operation without complications (Figure 1C).
CT scans. (A) Preoperative chest CT image showed left pleural effusion, collapsed lung and intragastric gas with an air-fluid level in the left thoracic cavity. (B) Coronal CT image demonstrating that the stomach had migrated into the thorax.
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F2
Emergency chest computed tomography (CT) demonstrated left pleural effusion, collapsed lung, and left DH, which allowed the stomach to herniate into the chest (Figures 2A,B).
Intraoperative findings of the second operation. (A) Contamination of the thoracic cavity with stomach contents. (B) Intraoperatively, a 6-cm-diameter diaphragmatic defect was found.
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F3
Intraoperatively, a contaminated thoracic cavity with stomach contents was observed, without pleural adhesions (Figure 3A). There was an approximately 6-cm diaphragmatic defect in the left posteromedial diaphragm, and the stomach had a 1-cm rupture and was herniated into the thorax through the defect (Figure 3B).