PMC9615624_01
Computed tomography showing the left diaphragmatic defect containing a segment of small intestine (yellow arrows)
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PMC9615624_01_10353_2022_782_Fig1_HTML.jpg
Fig1
Initial workup revealed leukocytosis (White blood cell count 14 k/uL) and a large left-sided diaphragmatic hernia containing a segment of small bowel without concern for compromise (Fig. 1).
Computed tomography of the chest. a Coronal section showing the left lung field completely replaced by incarcerated small intestine diaphragmatic hernia extending to the apex of the left pleural space (yellow arrows), and b an axial section demonstrating the same diaphragmatic hernia
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PMC9615624_01_10353_2022_782_Fig2_HTML.jpg
Fig2
Repeat imaging was concerning for bowel compromise and marked left-to-right mediastinal shift with large left pleural effusion (Fig. 2); hence, surgical intervention was deemed necessary that evening (12/5/2021).
View showing left thoracotomy exposure in a with frankly gangrenous small intestine and impending perforation. The gangrenous segment is seen more closely in b
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Fig3
Inspection revealed gangrenous small intestine in the upper chest with signs of impending perforation (Fig. 3).