Loss of weight and dyspnea
CT chest and upper abdomen
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A large left diaphragmatic hernia is seen. The diaphragmatic defect measuring 6 x 8 cm. It is seen admitting the whole stomach, small bowel loops and the transverse colon as well as the distal aspect of the superior mesenteric artery and its branches. The body, tail of pancreas and the splenic vessels are also seen herniating into the thorax. Its head and uncinate process as well as the C-loop of duodenum is seen at the upper abdomen immediately below the diaphragm.
Diminished volume of the left hemithorax with atelaectasis at the lingular segments of the upper lobe. Mediastinal shift to the right side ( heart and trachea).
Hepatosplenomegaly is also noted as well as minimal ascites.