CT
Coronal Soft tissue window with oral contrast
Oblique Annotated image
Axial Soft tissue window
There is marked wall thickening (mass) of the gastric fundus where there is a focal defect connecting the stomach to the pericardium transdiaphragmatically with subsequent large pneumopericardium and extra-luminal contrast leak. Axial image shows a small heart with flattening of the anterior border, bilateral pleural effusions and basal pulmonary collapse.