Fig. 1

Radiological imaging on day of admission. Thoraco-abdominal CT scan with localizer of carried out CT scan (a) and representative CT scan images (b, c): enterothorax with splenic flexure prolapse through an old undetected traumatic rupture of the left diaphragmatic center, consecutive colic incarceration (b + c; arrows) with ischemia, rupture of the colon into the left pleural cavity with feco-pneumothorax under tension, cardiac depression due to mediastinal shift to the right and sepsis secondary to left pleural empyema (c), inversed diaphragm and midline shift to the right (a + b). Post-surgical chest X-ray examination (d): re-expanded left lung and reversal of the mediastinal shift with reconstructed diaphragm