PMC5406523_01
Chest Xray AP view showing shift of the cardiac shadow to the right with note of bowel loops in the left thorax.
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Chest X-ray showed the presence of bowel loops in the left thorax and the cardiac shadow shifted to the right. (Fig. 1).
Coronal view of the Chest CT-scan IV and oral contrast showing gastric and bowel contents in the left hemithorax.
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The scan showed bowel loops in the left hemithorax with no masses noted in the chest (Fig. 2, Fig. 3).
Barium swallow outlining the gastric fundus, cardia and body which was located in the left hemithorax.
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No radiologic evidence of gastric volvulus was noted (Fig. 4, Fig. 5)
Diaphragm appears to be thinned out and attenuated intra-operatively.
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Intra-operatively, the diaphragm was noted to be thinned out with the central portion of the left diaphragm attenuated and membranous (Fig. 6).
1st layer of imbricating sutures to the diaphragm.
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The first layer was composed of heavy non absorbable silk sutures and the 2nd layer was a composed buttress suture of polyglycolic absorbable heavy sutures. (Fig. 7, Fig. 8)
Chest Xray taken on the first operative day showing atelectasis on the left lung.
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The patient was started on incentive spirometry and deep breathing exercises (Fig. 9).
Chest Xray taken 1 week post-operatively showing left lung expansion and elevated left hemidiaphragm.
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