PMC4955490_01
Standing antero posterior thoracic-abdominal X-ray
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F1
The standing antero posterior (AP) thoracic-abdominal X-ray [Figure 1] performed in the Emergency Department showed a diffuse opacity in the thorax with a central air-fluid level in the left hemithorax displacing the mediastinum on the right, fading of the left diaphragmatic cupola and significant colonic air-fluid levels in the abdomen.
Postero lateral hernia with incarceration of the transverse colon in the diaphragmatic defect
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F2
Exploration of the peritoneal cavity noted incarceration of the transverse colon in a defect measuring approximately 2 cm [Figure 2] in the posterolateral part of the left diaphragmatic cupola.
Start of hernia reduction: Necrotic bowel after sectioning of the neck of the hernia
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F3
After sectioning the neck of the hernia, the incarcerated intestine was reduced [Figure 3].
End of intestinal reduction
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F4
There was necrosis over 4 cm of the bowel [Figure 4].