Coronal and sagittal view shows defect in the anterior diaphragm posterior to the xiphoid process with herniation of mesenteric fat into anterior mediastinum. The right hemidiaphragm has an undulating appearance likely weakened by the defect. This allows mild protrusion of the left lobe of the liver, covered by the diaphragm, into the right hemithorax. This gives the double density appearance seen on the PA and lateral chest radiographs.